Riku-Jaakko Koivunen1, Jarno Satopää2, Elena Haapaniemi2, Daniel Strbian2, Atte Meretoja2, Satu Mustanoja2, Heli Silvennoinen2, Oili Salonen2, Mika Niemelä2, Turgut Tatlisumak2, Jukka Putaala2. 1. From the Departments of Neurology (R.-J.K., E.H., D.S., A.M., S.M., T.T., J.P.), Neurosurgery (J.S., M.N.), and Medical Imaging Center (H.S., O.S.), Helsinki University Central Hospital, Helsinki, Finland; and Departments of Medicine and Florey, University of Melbourne, Melbourne, Victoria, Australia (A.M.). riku.koivunen@helsinki.fi. 2. From the Departments of Neurology (R.-J.K., E.H., D.S., A.M., S.M., T.T., J.P.), Neurosurgery (J.S., M.N.), and Medical Imaging Center (H.S., O.S.), Helsinki University Central Hospital, Helsinki, Finland; and Departments of Medicine and Florey, University of Melbourne, Melbourne, Victoria, Australia (A.M.).
Abstract
BACKGROUND AND PURPOSE: Patient and radiological characteristics of intracerebral hemorrhage (ICH), surgical treatment, and outcome after ICH are interrelated. Our purpose was to define whether these characteristics or surgical treatment correlate with mortality among young adults. METHODS: We retrospectively reviewed clinical and imaging data of all first-ever nontraumatic patients with ICH between 16 and 49 years of age treated in our hospital between January 2000 and March 2010 and linked these data with national causes of death registry. A logistic regression analysis of factors associated with 3-month mortality and a propensity score comparison between patients treated conservatively and operatively was performed. RESULTS: Among the 325 eligible patients (59.4% men), factors associated with 3-month mortality included higher National Institutes of Health Stroke Scale score, infratentorial location, hydrocephalus, herniation, and multiple hemorrhages. Adjusted for these factors, as well as demographics, ICH volume, and the underlying cause, surgical evacuation was associated with lower 3-month mortality (odds ratio, 0.06; 95% confidence interval, 0.02-0.21). In propensity score-matched analysis, 3-month case fatality rates were 3-fold in those treated conservatively (27.5% versus 7.8%; P<0.001). CONCLUSIONS: The predictors of short-term case fatality are alike in young and elderly patients with ICH. However, initial hematoma evacuation was associated with lower 3-month case fatality in our young patients with ICH.
BACKGROUND AND PURPOSE:Patient and radiological characteristics of intracerebral hemorrhage (ICH), surgical treatment, and outcome after ICH are interrelated. Our purpose was to define whether these characteristics or surgical treatment correlate with mortality among young adults. METHODS: We retrospectively reviewed clinical and imaging data of all first-ever nontraumatic patients with ICH between 16 and 49 years of age treated in our hospital between January 2000 and March 2010 and linked these data with national causes of death registry. A logistic regression analysis of factors associated with 3-month mortality and a propensity score comparison between patients treated conservatively and operatively was performed. RESULTS: Among the 325 eligible patients (59.4% men), factors associated with 3-month mortality included higher National Institutes of Health Stroke Scale score, infratentorial location, hydrocephalus, herniation, and multiple hemorrhages. Adjusted for these factors, as well as demographics, ICH volume, and the underlying cause, surgical evacuation was associated with lower 3-month mortality (odds ratio, 0.06; 95% confidence interval, 0.02-0.21). In propensity score-matched analysis, 3-month case fatality rates were 3-fold in those treated conservatively (27.5% versus 7.8%; P<0.001). CONCLUSIONS: The predictors of short-term case fatality are alike in young and elderly patients with ICH. However, initial hematoma evacuation was associated with lower 3-month case fatality in our young patients with ICH.
Authors: Andreas Charidimou; Andrea Morotti; Raffaella Valenti; Anne-Katrin Giese; Gregoire Boulouis; Marco Pasi; Duangnapa Roongpiboonsopit; Arne Lauer; Li Xiong; Thijs Wijnzen Van Harten; Hasan Karadeli; Panagiotis Fotiadis; Michael James Jessel; Anand Viswanathan Journal: Neurology Date: 2016-05-17 Impact factor: 9.910
Authors: Riku-Jaakko Koivunen; Elena Haapaniemi; Jarno Satopää; Mika Niemelä; Turgut Tatlisumak; Jukka Putaala Journal: Stroke Res Treat Date: 2015-02-02
Authors: Laura C Miyares; Guido J Falcone; Audrey Leasure; Opeolu Adeoye; Fu-Dong Shi; Steven J Kittner; Carl Langefeld; Achala Vagal; Kevin N Sheth; Daniel Woo Journal: Neurology Date: 2020-01-22 Impact factor: 9.910