KASMEJ
Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

eISSN: 2757-9336
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Assessing characteristics, treatment approaches, and outcomes of spontaneous intracerebral hemorrhage patients in intensive care: a retrospective study
Abstract
Aims: Spontaneous intracerebral hemorrhage (SIH) is a common cerebrovascular disease associated with high mortality and poor clinical outcomes. This study aimed to investigate the fundamental characteristics of patients with SIH, their treatment practices, and early results to provide a comprehensive overview.
Methods: Patient records from 2017 to 2021 were reviewed following approval from the ethics committee of our hospital. Demographic data, surgical and medical treatments applied in the intensive care unit (ICU), and immediate clinical outcome data of patients meeting the study criteria were recorded and analyzed.
Results: A total of 153 patients were included in this study. The mortality rate in SIH patients was identified as 53.59%. The mean age value of those who died was found to be higher. In these patients, "fainting" as the initial symptom was found to be more common, while "Focal Neurological Deficits" were less common. A lower median Glasgow Coma Scale (GCS) and higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were also observed. It was noted that the fresh frozen plasma (FFP) usage rate was higher, whereas the usage rate of oral antihypertensives was lower in those who died. It was determined that 33.33 of patients, 33.33% were transferred to a service (neurology or neurosurgery), 11.76% received palliative care, and 1.31% received home care.
Conclusion: The mortality rate of patients with SIH is extremely high, and treatment in intensive care should be conducted according to current guidelines. More comprehensive studies are needed to standardize the appropriate treatment approaches. Alongside suitable treatment strategies to reduce mortality, identifying and supporting surviving patients' long-term treatment and rehabilitation needs are of great significance.

Keywords : Spontaneous intracerebral hemorrhage, mortality, predictors, anticoagulation, antihypertensive, intensive care unit

Download Article


1. An SJ, Kim TJ, Yoon B-W. Epidemiology, risk factors, and clinical featuresof intracerebral hemorrhage: an update. Journal of stroke. 2017;19(1):3.
2. Jain A, Malhotra A, Payabvash S. Imaging of spontaneous intracerebralhemorrhage. Neuroimaging Clinics. 2021;31(2):193-203.
3. Krishnamurthi RV, Ikeda T, Feigin VL. Global, regional and country-specific burden of ischaemic stroke, intracerebral haemorrhage andsubarachnoid haemorrhage: a systematic analysis of the global burden ofdisease study 2017. Neuroepidemiology. 2020;54(2):171-179.
4. Fallenius M, Skrifvars MB, Reinikainen M et al. Spontaneous intracerebralhemorrhage: Factors predicting long-term mortality after intensive care.Stroke. 2019;50(9):2336-2343.
5. Jolink WM, Klijn CJ, Brouwers PJ, Kappelle LJ, Vaartjes I. Time trendsin incidence, case fatality, and mortality of intracerebral hemorrhage.Neurology. 2015;85(15):1318-1324.
6. Jolink WM, Wiegertjes K, Rinkel GJ, Algra A, De Leeuw F-E, Klijn CJ.Location-specific risk factors for intracerebral hemorrhage: systematicreview and meta-analysis. Neurology. 2020;95(13):e1807-e1818.
7. Van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, KlijnCJ. Incidence, case fatality, and functional outcome of intracerebralhaemorrhage over time, according to age, sex, and ethnic origin: asystematic review and meta-analysis. The Lancet Neurology. 2010;9(2):167-176.
8. Roquer J, Rodríguez-Campello A, Jiménez-Conde J, et al. Sex-relateddifferences in primary intracerebral hemorrhage. Neurology. 2016;87(3):257-262.
9. Teles J, Martinez J, Mouzinho M, Guilherme P, Marreiros A, Nzwalo H.Gender differences in long-term mortality after spontaneous intracerebralhemorrhage in southern Portugal. Porto Biomedical Journal. 2021;6(4).e137
10. de Ridder I, Kuramatsu J, Gerner S, et al. No sex differences in long-term functional outcome after intracerebral hemorrhage. Intern J Stroke.2017;12(4):416-420.
11. Hu Y-z, Wang J-w, Luo B-y. Epidemiological and clinical characteristics of266 cases of intracerebral hemorrhage in Hangzhou, China. J Zhejiang UnSci B. 2013;14(6):496-504.
12. Jauch EC, Pineda JA, Hemphill JC. Emergency neurological life support:intracerebral hemorrhage. Neuro Care. 2015;23(Suppl 2):S83-S93.doi:10.1007/s12028-015-0167-0
13. Øie LR, Madsbu MA, Solheim O, et al. Functional outcome and survivalfollowing spontaneous intracerebral hemorrhage: a retrospectivepopulation-based study. Brain Behavior. 2018;8(10):e01113.
14. Martini SR, Flaherty ML, Brown WM, et al. Risk factors for intracerebralhemorrhage differ according to hemorrhage location. Neuro. 2012;79(23):2275-2282.
15. Sturgeon JD, Folsom AR, Longstreth Jr W, Shahar E, Rosamond WD,Cushman M. Risk factors for intracerebral hemorrhage in a pooledprospective study. Stroke. 2007;38(10):2718-2725.
16. Goeldlin MB, Siepen BM, Mueller M, et al. Intracerebral haemorrhagevolume, haematoma expansion and 3-month outcomes in patientson antiplatelets. a systematic review and meta-analysis. Euro Stroke J.2021;6(4):333-342.
17. Wu Y, Zhang D, Chen H, Liu B, Zhou C. Effects of prior antiplatelettherapy on mortality, functional outcome, and hematoma expansionin intracerebral hemorrhage: an updated systematic review and meta-analysis of cohort studies. Front Neuro. 2021;12:691357.
18. Rodríguez-Fernández S, Castillo-Lorente E, Guerrero-Lopez F, et al.Validation of the ICH score in patients with spontaneous intracerebralhaemorrhage admitted to the intensive care unit in Southern Spain. BMJopen. 2018;8(8):e021719.
19. Mendelow AD, Gregson BA, Rowan EN, Murray GD, Gholkar A, MitchellPM. Early surgery versus initial conservative treatment in patients withspontaneous supratentorial lobar intracerebral haematomas (STICH II): arandomised trial. Lancet. 2013;382(9890):397-408.
20. Li L, Molian VA, Seaman SC, et al. Impact of intracerebral hematomaevacuation during decompressive hemicraniectomy on functionaloutcomes. Stroke. 2021;52(3):1105-1108.
21. Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 Guideline for themanagement of patients with spontaneous intracerebral hemorrhage:a guideline from the American Heart Association/American StrokeAssociation. Stroke. 2022;53(7):e282-e361.
22. Hersh EH, Gologorsky Y, Chartrain AG, Mocco J, Kellner CP. Minimallyinvasive surgery for intracerebral hemorrhage. Cur Neuro Neurosci R.2018;18(6):1-7.
23. Wintzer S, Heckmann JG, Huttner HB, Schwab S. Dexamethasone inpatients with spontaneous intracerebral hemorrhage: an updated meta-analysis. Cerebrovascular Dis. 2020;49(5):495-502.
24. Virani SS, Alonso A, Benjamin EJ, et al. Heart disease and strokestatistics-2020 update: a report from the American Heart Association.Circulation. 2020;141(9):e139-e596.
25. Li X, Sun Z, Zhao W, Zhang J, Chen J, Li Y, et al. Effect of acetylsalicylicacid usage and platelet transfusion on postoperative hemorrhage andactivities of daily living in patients with acute intracerebral hemorrhage.J Neurosurg. 2013;118(1):94-103.
26. Hallan DR, Simion C, Rizk E. Early versus late tracheostomy inspontaneous intracerebral hemorrhage. Cureus. 2022;14(4).e24059.
27. Garcia RM, Prabhakaran S, Richards CT, Naidech AM, Maas MB. Race,socioeconomic status, and gastrostomy after spontaneous intracerebralhemorrhage. J Strok Cerebrovas Dis. 2020;29(2):104567.
Article available in :
Volume 3, Issue 3, 2023
Page : 132-138
https://doi.org/10.51271/KMJ-0113
Article Information
Received : 11 Jul 2023
Accepted : 09 Aug 2023
Published : 22 Sep 2023
Corresponding Author :

Asiye Demirel: Department of Anesthesiology and Reanimation, University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey

[email protected]
Citation : Ekin S, Demirel A, Ceylan İ, Eminoğlu Ş, Efsun Özgünay Ş. Assessing characteristics, treatment approaches, and outcomes of spontaneous intracerebral hemorrhage patients in intensive care: a retrospective study. Kastamonu Med J. 2023;3(3):132-138.

Read: 530
Cited: 0
Download : 480
_Footer