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Spontaneous ICH (spontaneous + ich)

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Medical Sciences	100%

Selected Abstracts

Spontaneous intracerebral hemorrhage in young adults

EUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2005
S.-L. Lai
Few studies have addressed intracerebral hemorrhage (ICH) in younger adults. We studied spontaneous ICH in adults ,45 years of age. We retrospectively reviewed patients hospitalized with ICH between 2000 and 2001 to investigate incidence, etiology, risk factors, bleeding sites, management, and prognosis. Patients (224 men, 72 women; 37.0 ± 7.7 years) had a mortality rate of 24%. The most common risk factor for mortality was hypertension (HTN) (48.7%). Bleeding was most common in the ganglion (49.0%). Multiple hemorrhages (83.3%) caused the highest mortality, with the most common cause of mortality being HTN (46.6%). Coagulopathy (62.5%) caused the highest mortality based on etiologic classification. Recurrent HTN-induced hemorrhage rate was 3.6%. In Taiwanese adults ,45 years of age, ICHs mainly involve the ganglion and result from HTN. Rates of HTN-induced hemorrhage are higher in Taiwan (46.6%) than elsewhere. Differences between races or countries should be investigated further. [source]

Hematology and coagulation parameters predict outcome in Taiwanese patients with spontaneous intracerebral hemorrhage

EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2005
H.-Y. Fang
Volume of intracerebral hemorrhage (ICH), Glasgow Coma Scale (GCS) score, peripheral edema around the hematoma, and hydrocephalus are good predictors of mortality in patients with spontaneous ICH from western countries. However, the significance of hematologic and biochemical parameters associated with spontaneous ICH has not been extensively studied. This study was designed to determine prognostic factors for spontaneous ICH in Taiwanese patients. We prospectively studied 109 consecutive patients with spontaneous ICH admitted to Changhua Christian Medical Center. Clinical and laboratory data were collected and analyzed. Mean age was 62.3 years. There were 63 men (58%) and 46 women (42%). Differences in GCS score, ICH score, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score between the survival and non-survival groups were statistically significant. Laboratory data were statistically different using multivariate analysis for platelet count, prothrombin time, and white cell count. This is the first study providing information on predictors of spontaneous ICH mortality in Taiwanese patients. The prothrombin time and platelet count on the first day were good early predictors of mortality. This finding in ethnically Chinese patients appears to be different from the profile for patients from western countries. [source]

Testing the outcome score of spontaneous intracerebral haemorrhage in haemodialysis patients

INTERNAL MEDICINE JOURNAL, Issue 10 2009
B.-R. Huang
Abstract The aim of this study is to determine the predictive value of the spontaneous intracerebral haemorrhage (ICH) outcome score (which we described previously) in haemodialysis (HD) patients who develop spontaneous ICH. The validation cohort consisted of all HD patients with spontaneous ICH presenting to Chang Gung Memorial Hospital in Taiwan during 2005,2007. The data were collected from one hospital and prospectively analysed, and the predictive model was tested using an external validation dataset. The prognostic factors were confirmed by chi-squared testing. We calculated the 30-day mortality in different groups of the validation cohort divided according to outcome score and tested the predictive value of the outcome score. The overall mortality rate was 52.6% in 38 HD patients. The originally identified prognostic factors were Glasgow Coma Scale score, age ,70 years, systolic blood pressure <130 or ,200 mmHg, ICH volume ,30 mL, presence of intraventricular haemorrhage and serum glucose ,8.8 mmol/L. All but one (serum glucose ,8.8 mmol/L (P= 0.07)) were subsequently found to be associated with 30-day mortality. In patients scoring 6 and 7, mortality was 100%, but in patients scoring 0, it was only 11.1%. The 30-day mortality in the validation cohort increased steadily with score and had good predictive value (correlation coefficient = 0.986, P < 0.001). Similar results in two different cohorts indicate that the ICH outcome score is a reliable outcome measure. [source]

Specificity and reliability of prognostic indexes in intensive care evaluation: the spontaneous cerebral haemorrhage case

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009
Alberto Barbieri PhD MD
Abstract Objective, To determine the reliability of a generic index such as Simplified Acute Physiology Score II (SAPSII), compared with a specific one Intra Cerebral Haemorrhage score (ICH score), as an intensive care unit (ICU) outcome predictor when evaluating a general facility that frequently treats a specific type of patients , those with spontaneous cerebral haemorrhage. Methods, The study cohort consisted of a random sample of patients (81) admitted to Modena's Policlinico Teaching Hospital's ICU with spontaneous ICH over a 24-month period. Main outcome measure, SAPSII, ICH score, overall mortality. Results, The mean ICH score for the 32 surviving patients was 3.41 ± 1.012 while for the 49 deceased patients was of 4.24 ± 0.855 (P = 0.000). The mean SAPSII value for the 32 surviving patients was 49.09 ± 16.58 while for the 49 deceased patients was 49.51 ± 15.93. SAPSII, ICH scores were analysed for mortality, by receiver operating characteristic curves: the area under the curve was significant for ICH, not-significant for SAPSII. Conclusions, Regional quality controls use generic prognostic indexes (SAPSII) in relation to mortality and outcome to assess ICUs, which is appropriate when dealing with a general facility when there is not a predominant type of patient, but it may bias the evaluation if the population with specific pathologies (ICH), not included in the general index, is statistically considerable, leading to an incorrect criticality assessment, an inappropriate strategic plan and the subsequent inefficient resource allocation. [source]

Seasonal variation of intracerebral haemorrhage in subjects with untreated hypertension

ACTA NEUROLOGICA SCANDINAVICA, Issue 1 2009
P. Saloheimo
Objectives,,, To explore the seasonality in the incidence of spontaneous intracerebral haemorrhage (ICH) in relation to the known risk factors in a population-based cohort. Materials and methods,,, All subjects with spontaneous ICH during a period of 3 years in Northern Ostrobothnia, Finland, were included. The associations of the risk factors for ICH with the cold (November to April) and warm (May to October) periods of the year were analysed. Results,,, We identified 217 patients with ICH during the study period. One hundred and seven cases occurred during the warm and 110 cases during the cold period. In multivariate analysis, untreated hypertension was associated with a 3.6-fold risk of ICH during the cold period (OR 3.60; 95% CI 1.27,10.21; P = 0.016). Conclusions,,, An excess risk of ICH in subjects with untreated hypertension seems to be associated with the cold season. This is probably explained by the effect of ambient temperature on blood pressure. [source]