Outcome predictor of spontaneous intracerebral hemorrhage management: Ten-year neurosurgical experience at ramathibodi hospital

Abstract

Objective: To determine the one-year outcome predictor for spontaneous intracerebral hemorrhage (sICH) patient population admitted to the Division of Neurosurgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. This was also to provide a better understanding to assist physicians and caregivers in evaluating sICH survivors during this first year after treatment. Material and Method: The authors reviewed brain computed tomographic films and medical records of all sICH cases admitted at Ramathibodi Hospital, Mahidol University between 1999 and 2009. One-year outcome predictors were determined using multiple logistic regression statistical analyses. Results: There were 537 cases with sICH diagnosis between 1999 and 2009. However, 239 cases were collected after online medical record review and 138 completed medical record files were retrieved. Modified Rankin Scale (mRS) was used to determine the authors' outcome treatment and categorized into two groups. The crucial group (mRS 5 and 6) and the favored group (mRS < 5) were compared. Volume of sICH and Initial hospitalization Glasgow Coma Scale were the significant predictors of one year treatment outcome for all locations of sICH. Using two classifications of intracerebral hemorrhage volume (less than 30 cc, and more than 30 cc) and three categories of the Glasgow Coma Scale (13-15, 9-12, and 8 or less), one year treatment outcome was predicted correctly with odd ratio and 95% confidence interval. Conclusion: Volume of sICH and initial hospitalization Glasgow Coma Scale is significantly influential to be one-year predictor in patients with sICH. The expectation of the treatment has to be discussed and planned for long-term management.