Predicting the overall management outcome in patients with a subarachnoid hemorrhage accompanied by a massive intracerebral or full-packed intraventricular hemorrhage: a 15-year retrospective study

Surg Neurol. 2005 Apr;63(4):329-34; discussion 334-5. doi: 10.1016/j.surneu.2004.04.028.

Abstract

Background: Patients with a subarachnoid hemorrhage (SAH) accompanied by a massive intracerebral hemorrhage (ICH) or a full-packed intraventricular hemorrhage (IVH) have poor outcomes. We evaluated the clinical factors to predict the overall outcome in such patients.

Methods: Data on nontraumatic SAH patients were collected and classified into 3 groups: the pure SAH group (SAH accompanied with neither ICH nor IVH), the ICH group (SAH accompanied with a massive ICH; hematoma 30 mL), and the IVH group (SAH and all ventricles were full-packed with hematoma). One hundred seventy-nine patients were in the ICH group and 109 in the IVH group. We evaluated clinical factors, such as the Hunt & Hess (H&H) score on admission, age, sex, history, rebleeding ratio, and the computerized tomography findings (SAH score).

Results: The result of multivariate logistic regression analysis of clinical variables in the ICH group, good and intermediate H&H grades, younger age (<70), no rebleeding, and lower SAH score were associated with a favorable outcome. In the result of the multivariate logistic regression analysis of clinical variables in the IVH group, only a higher SAH score was associated with an unfavorable outcome.

Conclusions: In the ICH group, factors that could be used to predict a favorable outcome included good and intermediate H&H scores (1, 2, and 3) on admission, younger age (<70), and a lower SAH score. In the IVH group, the main factor that could be used to predict a favorable outcome was a lower SAH score.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Cerebral Ventricles / blood supply*
  • Cerebral Ventricles / pathology*
  • Female
  • Hematoma
  • Humans
  • Intracranial Hemorrhages / complications*
  • Intracranial Hemorrhages / pathology
  • Intracranial Hemorrhages / therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / pathology
  • Subarachnoid Hemorrhage / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome