PROGNOSTIC PREDICTORS OF 30 DAY OUTCOME IN PATIENTS WITH NON –TRAUMATIC INTRAPARENCHYMAL HAEMORRHAGE

Abstract

BACKGROUND: Cerebrovascular diseases rank first in frequency and important among all neurologic diseases.  Intracranial hemorrhage includes:  1. Intraparenchymal hemorrhage  2 .Intra ventricular hemorrhage  3. Subarachnoid hemorrhage .Various factors have been studied to predict outcome including age, gender,  initial mean arterial blood pressure, temperature, volume of bleed, site of bleed,  intraventricular extension, mass effect and initial level of consciousness.

METHODS : This study is an observational study and was conducted in the ASRAM hospital with 100 sample size taken including patients with non traumatic intra parenchymal hemorrhage ,admitted to medical wards and ICU. This study excludes,1 Patients with history of Trauma 2. Patients with sub arachnoid hemorrhage alone 3. Patients with intra ventricular hemorrhage alone 4. Patients with previous history of intra parenchymal hemorrhage

RESULTS:  Mortality is high in extremes of age groups, particularly older age group, There is no persistent relation between the age and the mortality. Incidence of intra parenchymal hemorrhage is higher in males,  but the mortality rate is higher in the females. Temperature cannot serve as a prognostic predictor as the values were not applicable for bleed in all locations. Incidence of Intra parenchymal hemorrhage is high in patients who are not known hypertensives ,than in known hypertensives. Intra parenchymal hemorrhage  patients in order of importance according to this study are  i) Volume > 60ml  ii) Glassgow coma scale<8  iii)Presence of Intra ventricular hemorrhage iv)Mean arterial pressure >145mm of Hg.  

CONCLUSION:  Age, Gender, Temperature do not have a significant role in detecting the 30 day mortality rate in patients with Intra parenchymal hemorrhage. A case of  stroke with Intra cerebral hemorrhage with Mean arterial pressure < 145mm Hg, GCS > 8, Volume of Bleed < 30ml, in the absence of Intra ventricular hemorrhage  has 80% chance of survival after 30 days with the best National institutes of health stroke scale score