BACKGROUND: Surgical management of patients with thalamic hemorrhage lacks evidence of benefit
GENERAL OBJECTIVE: To compare the outcomes of patients with thalamic hemorrhage managed surgically and non-surgically, and to determine the predictors of mortality
SPECIFIC OBJECTIVES: To describe baseline demographic and clinical characteristics of patients with thalamic hemorrhage, determine which are predictors of mortality, and to compare the mortality rate of those managed surgically and non-surgically
METHODOLOGY: Data from patients with thalamic hemorrhage admitted within July 1, 2000 to June 30, 2003 were recorded. Univariate and multivariate analyses were done using SPSS for Windows v9.0. P0.05 was considered significant.
RESULTS AND CONCLUSIONS: Among 119 patients, average age was 58 years, predominantly males (68.3 percent), hypertensive (90.8 percent) and had IVE (79 percent). Obstructive hydrocephalus was present in 43.7 percent. Most common sign and symptom was hemiparesis. Prognostic factors significantly associated with mortality were GCS 12 (p30 cc (p=0.023), presence of obstructive hydrocephalus (p=0.003), hypertension (p=0.005) and ischemic heart disease (0.009). Patients in the surgical arm had a higher mortality rate (65 percent vs 37 percent), but surgery was not shown to be a significant predictor of mortality (p=0.23). The poorer outcome in surgical patients may be secondary to their having lower GCS scores, bigger hematoma sizes and greater frequency of hydrocephalus.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Multivariate Analysis ; Arm ; Hydrocephalus ; Hypertension ; Coronary Artery Disease ; Cerebral Hemorrhage ; Hematoma ; Paresis ; Demography ; Prognosis

BACKGROUND AND OBJECTIVE

A growing body of evidence supports that inflammatory mechanisms are involved in secondary brain injury after intracerebral hemorrhage (ICH) which has implications on the morbidity and mortality of stroke patients. Neutrophil-to-lymphocyte ratio (NLR) is a comprehensive index marker of inflammation and immune status of a patient. The prognostic value of NLR in predicting in-hospital mortality and functional outcome of patients with spontaneous intracerebral hemorrhage will be assessed in this study.

METHODS

We retrospectively selected 151 hemorrhagic stroke patients, and demographic and clinical characteristics were collected and computed for NLR. Receiver operating characteristic analysis using Youden’s index was utilized to determine the NLR cut-off value with the best sensitivity and specificity. The association of NLR with the inhospital mortality and functional outcome was assessed using Logistic regression analysis. Pearson Product Model Correlation was employed to evaluate the correlation of NLR with ICH volume.

RESULTS

Admission NLR >7 showed a significant association (p = <0.001 OR 7.99) with in-hospital mortality with a sensitivity of 70.83% and specificity of 72.82%. Furthermore, computed NLR of more than 6.4 showed significant association (p = 0.040 OR 2.92) with poor functional outcome. However, our study revealed that admission NLR showed a low level of correlation (r=0.2968, p=0.002) with the volume of ICH.

CONCLUSION

This study demonstrated that ICH patients with an elevated NLR is associated with increased inhospital mortality and poor functional outcome and that NLR can be used to predict clinical outcome among patients with spontaneous ICH.

Cerebral Hemorrhage ; Intracerebral Hemorrhage ; Hospital Mortality ; In-hospital Mortality