Artikel
Early predictors for in-hospital mortality in patients with spontaneous intracerebral haemorrhage
Frühzeitige Mortalitätsprädiktoren für Patienten mit spontaner intracerebraler Blutung
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Veröffentlicht: | 8. Mai 2019 |
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Objective: Intracerebral hemorrhage (ICH) is the second most common cause of stroke with 30 day mortality rates up to 50%. The aim of this study was to identify early predictors for intra-hospital mortality (IHM) in patients with spontaneous ICH.
Methods: A total of 329 patients with spontaneous ICH were retrospectively analysed. Blood samples were taken on admission to determine different serum biomarkers. In addition, demographic data, initial computed tomography scan as well as norepinephrine application rate (NAR) in µg/kg/min and inspiratory oxygen fraction (OF) within the first 24 hours underwent univariant analysis. Binary logistic regression analysis was used to identify independent prognostic factors for IHM. Intra-hospital outcome was determined by the modified Rankin Scale.
Results: The rate of IHM was 30.7% (n=107). Lower initial Glasgow Coma Scale (p<0.0001), lower cholinesterase level (p=0.004), increased NAR (p=0.002), advanced age (p<0.0001), elevated C-reactive protein level (p=0.024), elevated serum lactate level (p=0.003), high blood glucose levels (p=0.05), larger volume of intracerebral hematoma (p<0.0001), intraventricular hemorrhage (p=0.007), and hydrocephalus (p=0.009) on admission were significantly associated with increased IHM. NAR levels >0.5 µg/kg/min, an OF >0.21, age ≥71 years, hematoma volume ≥55 cm3, and GCS ≤7 were independent predictors of IHM in the multivariate analysis.
Conclusion: Higher levels of C-reactive protein, serum lactate, blood glucose and lower cholinesterase level (p=0.004) on admission were significantly associated with IHM. NAR >0.5 µg/kg/min and OF >0.21 were identified as new additional predictors for IHM in patients with spontaneous ICH.