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Revista Finlay
versão On-line ISSN 2221-2434
Resumo
SUAREZ QUESADA, Alexis et al. Mortality Prediction in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage. Rev. Finlay [online]. 2016, vol.6, n.1, pp. 32-40. ISSN 2221-2434.
Background: spontaneous intracerebral hemorrhage is the deadliest, most disabling, and least treatable form of stroke. No therapy has proven to improve its outcome or reduce its mortality. Objective: to identify predictors of mortality in patients with spontaneous supratentorial intracerebral hemorrhage. Methods: a single cohort study was conducted involving 176 patients admitted consecutively to the stroke ward of the Carlos Manuel de Céspedes Provincial General Hospital with neuroimaging and clinical diagnosis of spontaneous supratentorial intracerebral hemorrhage from January 2013 to November 2015. Independent predictors were obtained using multivariable logistic regression. Results: seventy four point four percent of the patients were hypertensive. The median age among those who died was 67.45 ± 14.84 years. Forty three point eight percent of the patients under study died. Subjects with fatal outcome had lower score on the Glasgow Coma Scale (10.00 ± 3.47 vs. 14.00 ± 1.93), higher hematoma volume expressed in cubic centimeters (26.27 ± 36.86 vs. 6.19 ± 19.59), and displacement of the midline structures (2.00 ± 5.95 vs. 0.00 ± 4.49). The following predictors were identified: Glasgow score ≤ 10 points (Exp (B): 10.74; 95 % CI=4.69 to 24.59), hematoma volume ≥ 20 cm3 (Exp (B): 4.44; 95 % CI= 1.95 to 10.06), and pulse pressure ≥ 60 mmHg (Exp (B): 2.42, 95 % CI=1.10 to 5.33). The area under the ROC curve was 0.85. Conclusions: the Glasgow Coma Scale is the most significant independent variable to predict mortality in patients with spontaneous intracerebral hemorrhage.
Palavras-chave : cerebral hemorrhage; prognosis; glasgow coma scale.