Marco Stein1, Gerhard F Hamann2, Björn Misselwitz3, Eberhard Uhl4, Malgorzata Kolodziej4, Marcus H T Reinges4. 1. Department of Neurosurgery, Justus Liebig University Giessen, Giessen, Germany. Electronic address: Marco.Stein@neuro.med.uni-giessen.de. 2. Department of Neurology, Bezirkskrankenhaus Günzburg, Günzburg, Germany. 3. Institute of Quality Assurance Hesse, Eschborn, Germany. 4. Department of Neurosurgery, Justus Liebig University Giessen, Giessen, Germany.
Abstract
OBJECTIVE: Secondary complications (SC) after intracerebral hemorrhage (ICH) can worsen outcome and are associated with early death. The purpose of the present study was to determine in-hospital mortality rates and SC after spontaneous ICH during acute care stay in a population-based cohort in central Europe. METHODS: A prospective database of the State of Hesse, Germany, was screened for all patients with the primary diagnosis of spontaneous ICH (International statistical classification-10: I61.0-I61.9) between January 2007 and December 2012. RESULTS: In the examined time period 10,029 patients with spontaneous ICH were identified. The cumulative rate of SC was 39.9% (1, 2, or ≥3 SC were documented in 25.0%, 10.1%, and 4.7%, respectively). The most common SC were pneumonia (15.1%), brain edema (6.5%), cardiac decompensation (5.9%), urogenital infection (5.5%), hydrocephalus (4.6%), epilepsy (3.4%), and rebleeding (3.4%). One, 2, or ≥3 SC were found in 2512 patients (25.0%), 1012 (10.1%), 473 (4.7%) patients, respectively. One SC was only a predictor of in-hospital mortality in conservatively treated patients (odds ratio [OR], 1.3; 95% confidence interval [CI] 1.2-1.5, P< 0.001). With an accumulation of SC to ≥3 the chance of in-hospital death increases for surgically (OR, 3.7, 95% CI 2.3-5.9; P< 0.001) and conservatively (OR, 3.0, 95% CI 2.3-3.9; P< 0.001) treated patients. CONCLUSIONS: Surgical treatment of hematomas is associated with an increased rate of SC, but not with higher mortality rates compared with conservatively treated patients. The prevention of an accumulation of SC could lead to a decrease of in-hospital mortality after spontaneous ICH.
OBJECTIVE: Secondary complications (SC) after intracerebral hemorrhage (ICH) can worsen outcome and are associated with early death. The purpose of the present study was to determine in-hospital mortality rates and SC after spontaneous ICH during acute care stay in a population-based cohort in central Europe. METHODS: A prospective database of the State of Hesse, Germany, was screened for all patients with the primary diagnosis of spontaneous ICH (International statistical classification-10: I61.0-I61.9) between January 2007 and December 2012. RESULTS: In the examined time period 10,029 patients with spontaneous ICH were identified. The cumulative rate of SC was 39.9% (1, 2, or ≥3 SC were documented in 25.0%, 10.1%, and 4.7%, respectively). The most common SC were pneumonia (15.1%), brain edema (6.5%), cardiac decompensation (5.9%), urogenital infection (5.5%), hydrocephalus (4.6%), epilepsy (3.4%), and rebleeding (3.4%). One, 2, or ≥3 SC were found in 2512 patients (25.0%), 1012 (10.1%), 473 (4.7%) patients, respectively. One SC was only a predictor of in-hospital mortality in conservatively treated patients (odds ratio [OR], 1.3; 95% confidence interval [CI] 1.2-1.5, P< 0.001). With an accumulation of SC to ≥3 the chance of in-hospital death increases for surgically (OR, 3.7, 95% CI 2.3-5.9; P< 0.001) and conservatively (OR, 3.0, 95% CI 2.3-3.9; P< 0.001) treated patients. CONCLUSIONS: Surgical treatment of hematomas is associated with an increased rate of SC, but not with higher mortality rates compared with conservatively treated patients. The prevention of an accumulation of SC could lead to a decrease of in-hospital mortality after spontaneous ICH.
Authors: Anna Lindner; Mario Kofler; Verena Rass; Bogdan Ianosi; Max Gaasch; Alois J Schiefecker; Ronny Beer; Sebastian Loveys; Paul Rhomberg; Bettina Pfausler; Claudius Thomé; Erich Schmutzhard; Raimund Helbok Journal: Front Neurol Date: 2019-08-06 Impact factor: 4.003
Authors: Marco Stein; Björn Misselwitz; Gerhard F Hamann; Malgorzata A Kolodziej; Marcus H T Reinges; Eberhard Uhl Journal: Biomed Res Int Date: 2016-03-27 Impact factor: 3.411
Authors: Paulo Henrique Rosado-de-Castro; Felipe Gonçalves de Carvalho; Gabriel Rodriguez de Freitas; Rosalia Mendez-Otero; Pedro Moreno Pimentel-Coelho Journal: Stem Cells Int Date: 2016-09-06 Impact factor: 5.443