Analysis of outcome predictors in patients with spontaneous intracerebral hemorrhage

Introduction. Spontaneous intracerebral hemorrhage is not a monophasic event, but a condition characterized by hematoma expansion with mechanical damage to the surrounding tissue. The development of multiple complications is associated with a high mortality rate of 40%. In order to make therapeutic decisions, it is important to know what factors predict the outcome in these patients. The aim of this study was to evaluate outcome prediction scales in patients with spontaneous intracerebral hemorrhage according to functional outcome at 7 and 30 days after the onset. Material and Methods. A three-year retrospective study (2017 - 2019) included 116 patients treated at the Emergency Center, Clinical Center of Vojvodina, Novi Sad, Serbia. The collected data included the National Institutes of Health Stroke Scale, the original intracerebral hemorrhage score, the modified Graeb score and Glasgow coma scale. Demographic data, localization, shape and volume of hematomas, as well as occurrence of intraventricular hemorrhage were compared. Results. In the group of 116 patients, male gender was dominant (82%) as well as the age over 65 years (56%); Glasgow coma scale: 1.5 interquartile range = 1 - 2 points, National Institutes of Health Stroke Scale 24, interquartile range = 15 - 32, intracerebral hemorrhage score 3 - 4 (68.1%). Intraventricular hemorrhage was found in 82.3% and oval hematoma in 71.6% of patients. The mortality rate was highest in the first 7 days (41.4%). The 7-day and 30-day mortality was significantly associated with the intracerebral hemorrhage score (p = 0.000) and the intracerebral hemorrhage volume (p = 0.014). Conclusion. Elderly men with known vascular risk factors are prone to spontaneous intracerebral hemorrhage. The intracerebral hemorrhage score and hematoma volume may be the potential indicators of poor outcome in the first 7 days of spontaneous intracerebral hemorrhage.