ORIGINAL ARTICLES   Free access

Europa Medicophysica 1999 March;35(1):35-40

Copyright © 1999 EDIZIONI MINERVA MEDICA

lingua: Inglese

Predictors of long-term case fatality (one-year) in primary intracerebral hemorrhage

Zorzon M., Masè G., Biasutti E., Vitrani B., Cazzato G.

Neurologic Clinic, University of Trieste, Italy

BACKGROUND: To deter­mine, on clin­i­cal and radio­log­i­cal ­grounds, the prog­nos­tic fac­tors ­which may be asso­ciat­ed ­with the ­long-­term sur­vi­val ­after pri­mary intra­cer­e­bral hem­or­rhage.
METHODS: Design: prospective fol­low-up ­study. Setting: Hospitalized ­care. Patients: 126 con­sec­u­tive ­patients hos­pi­tal­ized with­in 24 ­hours of ­onset of supra­ten­to­ri­al pri­mary intra­cer­e­bral hem­or­rhage. The diag­no­sis was con­firmed by CT ­scan of the ­skull. No ­patient was ­lost to fol­low-up. Main out­come: potential ­risk fac­tors (clin­i­cal and radio­log­i­cal var­i­ables) for ­death ­were stud­ied pros­pec­tive­ly up to one ­year ­after hem­or­rhage.
RESULTS: In step­wise mul­ti­var­i­ate logis­tic regres­sion anal­y­sis, intra­ven­tric­u­lar spread­ing of the hem­or­rhage, ­large hem­or­rhage ­size, low Glasgow Coma Scale ­score and ­limb pare­sis (i.e. the ­patient can­not com­plete­ly over­come grav­ity in the ­range of ­motion) ­were sig­nif­i­cant inde­pen­dent pre­dic­tors of one-­year ­case fatal­ity.
CONCLUSIONS: The ­results sug­gest ­that ­long-­term ­case fatal­ity ­after an intra­cer­e­bral hem­or­rhage cor­re­lates ­with the sever­ity of ana­tom­i­cal ­lesions on CT and the lev­el of con­scious­ness on admis­sion, and ­also ­with the sever­ity of ­motor def­i­cits, imply­ing ­that the com­pli­ca­tions of rel­a­tive immo­bil­iza­tion can ­affect the ­long-­term prog­no­sis of pri­mary intra­cer­e­bral hem­or­rhage. Therefore eve­ry ­effort ­should be ­made to ­initiate reha­bil­i­ta­tion as ­soon as pos­sible to ­avoid the com­pli­ca­tions of immo­bil­ity.