Skip to main content
Journal cover image

Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage.

Publication ,  Journal Article
Sun, W; Pan, W; Kranz, PG; Hailey, CE; Williamson, RA; Sun, W; Laskowitz, DT; James, ML
Published in: Neurocrit Care
December 2013

BACKGROUND: Although intracerebral hemorrhage (ICH) is a common form of cerebrovascular disease, little is known about factors leading to neurological deterioration occurring beyond 48 h after hematoma formation. The purpose of this study was to characterize the incidence, consequences, and associative factors of late neurological deterioration (LND) in patients with spontaneous ICH. METHODS: Using the Duke University Hospital Neuroscience Intensive Care Unit database from July 2007 to June 2012, a cohort of 149 consecutive patients with spontaneous supratentorial ICH met criteria for analysis. LND was defined as a decrease of two or more points in Glasgow Coma Scale score or death during the period from 48 h to 1 week after ICH symptom onset. Unfavorable outcome was defined as a modified Rankin Scale score of >2 at discharge. RESULTS: Forty-three subjects (28.9 %) developed LND. Logistic regression models revealed hematoma volume (OR = 1.017, 95 % CI 1.003-1.032, p = 0.019), intraventricular hemorrhage (OR = 2.519, 95 % CI 1.142-5.554, p = 0.022) and serum glucose on admission (OR = 2.614, 95 % CI 1.146-5.965, p = 0.022) as independent predictors of LND. After adjusting for ICH score, LND was independently associated with unfavorable outcome (OR = 4.000, 95 % CI 1.280-12.500, p = 0.017). In 65 subjects with follow-up computed tomography images, an increase in midline shift, as a surrogate for cerebral edema, was independently associated with LND (OR = 3.822, 95 % CI 1.157-12.622, p = 0.028). CONCLUSIONS: LND is a common phenomenon in patients with ICH; further, LND appears to affect outcome. Independent predictors of LND include hematoma volume, intraventricular hemorrhage, and blood glucose on admission. Progression of perihematomal edema may be one mechanism for LND.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

December 2013

Volume

19

Issue

3

Start / End Page

299 / 305

Location

United States

Related Subject Headings

  • Time Factors
  • Prognosis
  • Predictive Value of Tests
  • Patient Outcome Assessment
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hematoma
  • Glasgow Coma Scale
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sun, W., Pan, W., Kranz, P. G., Hailey, C. E., Williamson, R. A., Laskowitz, D. T., & James, M. L. (2013). Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage. Neurocrit Care, 19(3), 299–305. https://doi.org/10.1007/s12028-013-9894-2
Sun, Weiping, Wenqin Pan, Peter G. Kranz, Claire E. Hailey, Rachel A. Williamson, Wei Sun, Daniel T. Laskowitz, and Michael L. James. “Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage.Neurocrit Care 19, no. 3 (December 2013): 299–305. https://doi.org/10.1007/s12028-013-9894-2.
Sun W, Pan W, Kranz PG, Hailey CE, Williamson RA, Laskowitz DT, et al. Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage. Neurocrit Care. 2013 Dec;19(3):299–305.
Sun, Weiping, et al. “Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage.Neurocrit Care, vol. 19, no. 3, Dec. 2013, pp. 299–305. Pubmed, doi:10.1007/s12028-013-9894-2.
Sun W, Pan W, Kranz PG, Hailey CE, Williamson RA, Laskowitz DT, James ML. Predictors of late neurological deterioration after spontaneous intracerebral hemorrhage. Neurocrit Care. 2013 Dec;19(3):299–305.
Journal cover image

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

December 2013

Volume

19

Issue

3

Start / End Page

299 / 305

Location

United States

Related Subject Headings

  • Time Factors
  • Prognosis
  • Predictive Value of Tests
  • Patient Outcome Assessment
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Hematoma
  • Glasgow Coma Scale