Intracerebral hemorrhage survival: French register data

Cerebral hemorrhages are subject to a heavy short- and long-term case fatal ity. A study of prognostic factors and of relative survival based on the da ta of a population registry is of great value to study patients having a he matoma of all ages, irrespective of the method of care. We have listed 183 patients having a cerebral hemorrhage between 1 January 1985 and 31 Decembe r 1996 and living in the city of Dijon, France. Eighteen clinical and CT-sc anning variables have been studied. We have found four predictive factors o f death at one month from cerebral hemorrhages. These are, in decreasing or der: the existence of consciousness disorders at the initial clinical exami nation (OR = 5.80 p < 0.0001); an intraventricular hemorrhage (OR = 5.60, p < 0.0001); a hematoma volume over If; cubic centimeters (OR = 3.53, p = 0. 027); lastly, in male patients an age over 70 years (OR = 4.90, p = 0.039). With regard to long-term survival, the existence of consciousness disorder s remains the principal predictive factor of case fatality in both crude an d relative survival (OR = 5.52, p < 0.0001, in crude survival versus OR = 2 2.2 in relative survival, p < 0.0001) followed by age over 70 years (OR = 3 .71, p < 0.0001 in crude survival and OR = 2.41 in relative survival, p = 0 .086). The existence of consciousness disorders at the initial examination following a cerebral hemorrhage would seem to be the principal worst progno stic factor of short- and long-term survival and of relative survival, age and sex having less importance. Moreover, intraventricular hemorrhage and h ematoma volume are short-term, pejorative factors. These data, based on a p opulation-based registry, are an important consideration in the acute manag ement of hemorrhagic therapy, and for the design of further therapeutic tri als on this severe pathology.