Artikel
Early predictors during acute care of intra-hospital outcome in patients with spontaneous intracerebral haemorrhage
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Autoren
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Michael Bender
- Justus-Liebig-Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
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Tim Naumann
- Justus-Liebig-Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
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Katharina Graf
- Justus-Liebig-Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
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Eberhard Uhl
- Justus-Liebig-Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
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Marco Stein
- Justus-Liebig-Universität Gießen, Klinik für Neurochirurgie, Gießen, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: Spontaneous intracerebral haemorrhage (SICH) is with 10-15% the second most common cause of stroke and is associated with a high morbidity and mortality. This study was conducted to investigate the influence of early clinical predictors during acute care on intra-hospital outcome in patients with SICH.
Methods: All patients with SICH admitted to our department from 02/2008 to 12/2016 were included in this analysis .The influence of demographic parameters, initial Glasgow Coma Score (GCS), average arterenol application rate in µg/kg/min (AAR), and inspiratory oxygen fraction (OF) within the first 24 hours of intensive care treatment were analyzed. The target values of systolic blood pressure were 120 to 140 mmHg and ≥ 95% for oxygen saturation. Furthermore, blood glucose value in mmol/l (BG), hemoglobin value in g/dl (HGV) and leukocyte values in G/l (LV) were determined in the initial blood sample. The initial hematoma volume (HV) was calculated. Intra-hospital outcome was evaluated with the modified Rankin scale (mRs) at discharge. Favorable outcome (FO) was defined as mRs 0-3, unfavorable outcome (UO) as mRs 4-5 and lethal outcome as mRs 6. Patients were stratified into 3 cohorts: FO, UO and LO.
Results: 101 patients with a median age of 72 years (range: 37-90) were identified. 57 patients were female (56.4%) and 44 were male (43.6%). Intra-hospital mortality was 29.7% (N=30). 26 patients had a FO and 45 patients an UO at discharge. We observed no significant difference with regard to HV (p=0.06), HGV (p=0.2), LV (p=0.3) and age (p=0.1) between the three cohorts. Patients with LO had a significant higher BG (p=0.005) on admission and higher AAR (p=0.005) within the first 24 hours compared to patients with FO. Furthermore, a significant lower GCS (p=0.001) and higher OF (p=0.013) within the first 24 hours were observed in patients with LO compared to the cohorts FO and UO.
Conclusion: We identified BG, AAR, and OF as possible new predictors of intra-hospital outcome. These predictors should be analyzed and confirmed in larger datasets.
