Predictors of 30 days mortality in patients with primary intracerebral hemorrhage in Mukdahan hospital
Keywords:
Primary intracerebral hemorrhage, prognostic factor, Multivariate analysis, ICH scoringAbstract
Objective : To study the factors affecting mortality in the 30 days after admission in patients diagnosed with primary intracerebral hemorrhage (ICH).
Materials and methods : This retrospective cohort study was conducted using medical records of patients who diagnosed with primary ICH, between July 2017 and August 2020 at Mukdahan Hospital to evaluate possible predictors of 30 days mortality considering patients’ characteristics, cranial CT finding and therapeutic procedures with logistic regression analysis.
Results : 330 patients (mean age: 61 years, mean Glasgow Coma Score (GCS) on admission: 11, mean ICH volume: 26 ml., most common hematoma location: basal ganglion (56.06%)) were enrolled. The 30 days mortality rate was 26.9%. 62 received surgical and 268 conservative treatment. Multivariable analyses demonstrated that the prognostic factors of early mortality in ICH patients were female (OR = 2.96, 95% CI = 1.27-7.01, P = 0.015), GCS score on admission ≤ 8 (OR = 16.9, 95% CI = 7.20-39.66, P = <0.01), renal failure ≥stage 2 (OR = 2.99, 95% CI = 1.27-7.01, P = 0.012), heart disease (OR = 6.15, 95% CI = 0.64-59.0, P = 0.11), infratentorial hematoma location ( OR = 12.38, 95% CI = 3.83-40.0, P = <0.01), IVH ( OR = 3.799, 95%CI = 1.69-8.50, P = 0.001), hematoma volume ≥30 ml. (OR = 2.97, 95% CI = 0.97-9.00, P = 0.054), midline shift ≥5 mm. (OR = 4.69, 95% CI = 1.67-13.16, P = 0.003) and these factors can be used to make the ICH scoring to predict the patient’s prognosis which has an accuracy of 93%.
Conclusion : GCS on admission together with female, infratentorial hematoma volume, IVH, midline shift ≥ 5 mm. ,heart disease and chronic renal failure stage 3 and above were strong predictor for 30 days mortality in patient with primary ICH. The ICH scoring accurately to predict 30 days mortality.
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