Factors Associated with Severity on Admission and In-Hospital Mortality after Primary Intracerebral Hemorrhage in China

Abstract

Background and purpose Of the stroke types, intracerebral hemorrhage is the most debilitating and fatal. The aim of the current study was to determine factors that influence the severity and in-hospital mortality after primary intracerebral hemorrhage. Methods Data were collected retrospectively on 1268 patients with primary intracerebral hemorrhage admitted to stroke units at participating hospitals in Guangzhou between January 2005 and August 2008. Logistic regression analysis was used to determine factors associated with severity on admission and in-hospital mortality. Results Of the 1268 patients, 20·4% were reported to have a severe stroke on admission, and the in-hospital mortality rate was 12·5%. Severity on admission was strongly associated with Glasgow Coma Scale score on admission (odds ratio = 0·89, 95% confidence interval 0·85–0·94) and hematoma location. Notably, basal ganglia hemorrhages were associated with increased severity (odds ratio = 1·40, 95% confidence interval 1·03–1·90), and cerebellar hemorrhages were associated with reduced severity (odds ratio = 0·29, 95% confidence interval 0·10–0·84). In-hospital mortality was not only correlated with Glasgow Coma Scale score on admission (odds ratio = 0·79, 95% confidence interval 0·74–0·84) and basal ganglia location (odds ratio = 0·47, 95% confidence interval 0·26–0·83), but also with dysnatremia (odds ratio =1·91, 95% confidence interval 1·08–3·40) and comorbidities such as upper gastrointestinal hemorrhage (odds ratio = 2·28, 95% confidence interval 1·33–3·91), pneumonia (odds ratio = 3·50, 95% confidence interval 2·17–5·63), urinary incontinence (odds ratio = 2·22, 95% confidence interval 1·40–3·51), and renal dysfunction (odds ratio = 2·28, 95% confidence interval 1·42–3·65). Conclusion Glasgow Coma Scale score and hematoma locations were independently associated with severity on admission and in-hospital mortality after primary intracerebral hemorrhage. The study also highlights the deleterious effect of comorbidities on in-hospital mortality following primary intracerebral hemorrhage in China.