Clinical Insights and Treatment Outcomes in Intracerebral Hemorrhage Patients

Introduction: Spontaneous intracerebral hemorrhage presents a significant public health challenge. This study aims to examine clinical and radiomorphological factors that influence the outcome and to provide a comprehensive analysis of long-term prognosis, identify risk factors for unfavorable outcomes, and explore treatment influences on patient survival and recovery. By addressing these objectives, we contribute to better intracerebral hemorrhage management and informed clinical decisions, offering hope for reduced mortality and improved functional survival.

Methods: The study's primary objective is to provide an analysis of the long-term prognosis for individuals experiencing spontaneous intracerebral hemorrhage while simultaneously identifying potential risk factors that could forecast adverse outcomes. The investigation entailed a comprehensive assessment of 309 patients who received treatment for spontaneous intracerebral hemorrhage at our clinic from 2007 to 2015.
The patient cohort encompassed a diverse demographic, with 160 males (51.78%) and 149 females (48.22%). The study tracked these patients for a duration of two years following their initial presentation.

Results: In our study of 309 patients treated for spontaneous intracerebral hemorrhage. One month post-hemorrhage, the conservative group had a 15.86% mortality rate, with 5.83% achieving a favorable mRS of 0-2, and 78.32% an unfavorable mRS of 3-5. Meanwhile, the operative group had 19.5% mortality, with 54.5% having an unfavorable mRS of 3-5. After two years, the conservative group had a 30.1% mortality rate, with 58 patients achieving a favorable mRS of 0-2 and 72 with an mRS of 3-5. In the operative group, 24 patients had passed away. The type of treatment significantly correlated with patient outcomes (P = 0.019) and mortality (P < 0.010; OR = 0.386; 95% CI = 0.186 – 0.800), while age, GCS, diabetes, and anticoagulant medication also influenced morbidity and mortality.

Conclusion : The study reveals that factors such as diabetes mellitus, age, hemorrhage volume, Glasgow Coma Scale, and pre-existing anticoagulation therapy impact patient morbidity and mortality. The decision to treat spontaneous intracerebral hemorrhage should be tailored based on the patient's medical history and condition. The surgical intervention timing is often emergent.