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Malinova, Vesna; Iliev, Bogdan; Mielke, Dorothee; Rohde, Veit

Intracerebral Hemorrhage-Score Allows a Reliable Prediction of Mortality in Patients with Spontaneous Intracerebral Hemorrhage Managed by Fibrinolytic Therapy

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  • Medientyp: E-Artikel
  • Titel: Intracerebral Hemorrhage-Score Allows a Reliable Prediction of Mortality in Patients with Spontaneous Intracerebral Hemorrhage Managed by Fibrinolytic Therapy
  • Beteiligte: Malinova, Vesna; Iliev, Bogdan; Mielke, Dorothee; Rohde, Veit
  • Erschienen: S. Karger AG, 2019
  • Erschienen in: Cerebrovascular Diseases
  • Sprache: Englisch
  • DOI: 10.1159/000504246
  • ISSN: 1015-9770; 1421-9786
  • Schlagwörter: Cardiology and Cardiovascular Medicine ; Neurology (clinical) ; Neurology
  • Entstehung:
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  • Beschreibung: <jats:p>&lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; Intracerebral hemorrhage (ICH) is associated with high morbidity and mortality. Prognosis estimation would be helpful for the treatment decision making in ICH patients. The ICH-score was published in 2001 to estimate the 30-day mortality in conservatively treated patients with ICH. We evaluated the reproducibility of the ICH-score in ICH patients undergoing fibrinolytic therapy. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We performed a retrospective analysis of patients with supratentorial ICH managed by fibrinolytic therapy and evaluated the 30-day mortality. The ICH-score was then applied to match the mortality in our patients with the mortality predicted by the ICH-score. The ICH-score is based on parameters available at admission: age, hematoma volume, intraventricular expansion, and clinical status according to the Glasgow Coma Scale. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A total of 233 patients were analyzed. The 30-day mortality rate was 30% (70/233). An age of ≥80 years was associated with a significantly higher mortality rate (OR 2.26, chi-square test &lt;i&gt;p&lt;/i&gt; = 0.01). A hematoma volume of ≥30 mL led significantly more often to 30-day mortality (OR 3.72, chi-square test &lt;i&gt;p&lt;/i&gt; = 0.01). The mortality was significantly higher in the patients with intraventricular hemorrhage (2.97, chi-square test &lt;i&gt;p&lt;/i&gt; = 0.003). The ICH-score showed a significant correlation with mortality (chi-square test, &lt;i&gt;p&lt;/i&gt; &amp;#x3c; 0.0001). The following mortality rates were estimated using the ICH-score in our cohort: 1 = 0% (0/13), 2 = 0% (0/51), 3 = 1.3% (1/82), 4 = 43% (13/31), 5 = 100% (56/56). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; The ICH-score not only allows a reliable estimation of the 30-day mortality in patients with ICH treated conservatively but also treated by clot lysis. Compared to conservative treatment, the fibrinolytic therapy reduced the 30-day mortality in the patients with ICH-scores 1–4. Patients with ICH-score 5 do not have a benefit of fibrinolytic therapy and should no longer be considered to be candidates for fibrinolytic therapy.</jats:p>