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Risk factors for 1‐year mortality in patients with nontraumatic intracranial hemorrhage requiring intensive care
Author(s) -
JUNTTILA E. K.,
KOSKENKARI J.,
ROMPPAINEN N.,
OHTONEN P. P.,
KARTTUNEN A.,
ALAKOKKO T. I.
Publication year - 2011
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2011.02512.x
Subject(s) - medicine , intensive care unit , intracerebral hemorrhage , subarachnoid hemorrhage , intensive care , proportional hazards model , unconsciousness , level of consciousness , retrospective cohort study , hazard ratio , anesthesia , intensive care medicine , confidence interval
Background Mortality in patients with intracranial hemorrhage remains high. The aim of this study was to determine the 1‐year survival and potential risk factors for 1‐year mortality in patients with nontraumatic intracranial hemorrhage requiring intensive care. Methods This was a 3‐year (2005–2007) retrospective study in a university‐level intensive care unit ( ICU ). Patient characteristics, level of consciousness, and radiological findings of the primary head computed tomography were recorded on admission. S equential O rgan F ailure A ssessment scores were recorded during the ICU stay. Patients were divided into two groups: subarachnoid hemorrhage ( SAH ) group and intracerebral hemorrhage ( ICH ) group. K aplan– M eier survival curves were constructed, and independent risk factors were determined using C ox proportional hazards regression analyses. Results Two hundred twenty‐nine patients were analyzed. The 1‐year mortality rate was 32% in patients with SAH and 44% in patients with ICH . The risk factors for 1‐year mortality in both groups were unconsciousness on admission [ SAH : hazard ratio ( HR ) 6.2, P = 0.017 and ICH : HR 3.0, P = 0.004] and renal failure during the ICU stay ( SAH : HR 2.5, P = 0.021 and ICH : HR 3.6, P = 0.021). Risk factors specific to the type of hemorrhage were the presence of ICH ( HR 2.0, P = 0.033) and diffuse cerebral edema ( HR 2.3, P = 0.017) in the SAH group and a prior use of warfarin ( HR 5.1, P = 0.016) in the ICH group. Conclusions In addition to decreased level of consciousness on admission, renal failure during the ICU stay is an independent risk factor for 1‐year mortality in nontraumatic SAH as well as ICH .