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Predictors of good outcome in medium to large spontaneous supratentorial intracerebral haemorrhages
- Source :
- Journal of Neurology, Neurosurgery & Psychiatry. 76:691-695
- Publication Year :
- 2005
- Publisher :
- BMJ, 2005.
-
Abstract
- To determine potential predictors of good outcome in primary medium to large intracerebral haemorrhages (ICH) which could be useful for selecting patients for surgical procedures.Subjects were 138 patients with spontaneous hemispheric ICH20 ml. They were non-surgically treated and were admitted consecutively to 15 hospitals within the first 12 hours of symptom onset (mean (SD), 5.8 (3.1) hours). Haematoma volume was measured on computed tomography (CT) at admission. Stroke severity was assessed by the Canadian stroke scale (CSS). Good outcome was defined as modified Rankin scoreor =2 at three months.At the end of the follow up period, 45 patients (32.6%) had good outcome. Baseline stroke severity, systolic and diastolic blood pressure, body temperature, and acute phase reaction biochemical markers (ESR, C-reactive protein, fibrinogen, neutrophil count) were significantly associated with good outcome in bivariate analyses. Of the initial CT scan variables, intraventricular contamination, deep location, mass effect, and greater ICH volume were related to poor outcome. On multiple logistic regression analysis, cortical location of bleeding (odds ratio 3.79 (95% confidence interval 1.2 to 12.01); p = 0.023), high CSS score (OR 2.3 (1.6 to 3.1); p0.0001), and low fibrinogen concentrations (OR 0.92 (0.87 to 0.97); p = 0.001) were independent predictors of good outcome. These three factors correctly classified 85% of patients.Good outcome in medium to large ICH can be predicted on admission by three readily assessable factors (CSS score, ICH location, and fibrinogen levels). These predictors may be helpful in selecting patients for surgical treatment.
- Subjects :
- Paper
Male
Neutrophils
Blood Pressure
Hemiplegia
Severity of Illness Index
Neurosurgical Procedures
Body Temperature
Severity of illness
Humans
Medicine
Prospective Studies
cardiovascular diseases
Prospective cohort study
Stroke
Aged
Cerebral Hemorrhage
business.industry
Vascular disease
Patient Selection
Fibrinogen
Odds ratio
medicine.disease
Confidence interval
nervous system diseases
Psychiatry and Mental health
C-Reactive Protein
Treatment Outcome
Blood pressure
Anesthesia
Absolute neutrophil count
Female
Surgery
Neurology (clinical)
Tomography, X-Ray Computed
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00223050
- Volume :
- 76
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology, Neurosurgery & Psychiatry
- Accession number :
- edsair.doi.dedup.....2df49ecbcabd4e7e8f00849f97d5f4a9