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  • Title: Extent of secondary intraventricular hemorrhage is an independent predictor of outcomes in intracerebral hemorrhage: data from the Helsinki ICH Study.
    Author: Mustanoja S, Satopää J, Meretoja A, Putaala J, Strbian D, Curtze S, Haapaniemi E, Sairanen T, Niemelä M, Kaste M, Tatlisumak T.
    Journal: Int J Stroke; 2015 Jun; 10(4):576-81. PubMed ID: 25580771.
    Abstract:
    BACKGROUND: Intraventricular hemorrhage is a severe subtype of intracerebral hemorrhage associated with high mortality and poor outcome. AIM: We analyzed various intraventricular hemorrhage scores at baseline to find common parameters associated with increased mortality. METHODS: Consecutive intracerebral hemorrhage patients treated in Helsinki University Central Hospital during 2005-2010 were included in the Helsinki Intracerebral Hemorrhage Study registry and analyzed for three-month mortality. RESULTS: After excluding lost-to-follow-up patients, 967 intracerebral hemorrhage patients were included, out of whom 398 (41%) had intraventricular hemorrhage. Intraventricular hemorrhage patients, compared with nonintraventricular hemorrhage patients, had lower baseline Glasgow Coma Scale [median 12 (IQR 6-15) vs. 15 (13-15); P < 0.001] and higher National Institutes of Health Stroke Scale [18 (10-27) vs. 7 (3-14); P < 0.001] scores; larger intracerebral hemorrhage volumes [17 ml (7.2-42) vs. 6.8 (2.4-18); P < 0.001] and more often hydrocephalus (51% vs. 9%; P < 0.001); and higher mortality rates (54% vs. 18%; P < 0.001). In multivariable analysis, the presence of intraventricular hemorrhage was independently associated with mortality [OR 2.05 (95% CI 1.36-3.09)] when adjusted for well-known prognostic factors of intracerebral hemorrhage, i.e. age, gender, baseline National Institutes of Health Stroke Scale, intracerebral hemorrhage volume, infratentorial location, and etiology. CONCLUSIONS: The presence of intraventricular hemorrhage was independently associated with increased mortality, and all the intraventricular hemorrhage scores were strong predictors of three-month mortality.
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