Long-term prognosis of intracerebral hemorrhage

• Published in: Japanese Journal of Stroke Vol. 22; no. 4; pp. 663 - 667
• Main Authors: Suzuki, Norihiro, Kanda, Tadashi, Fukuda, Mitinari, Sakai, Fumihiko, Iizuka, Takahiro
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 2000
• Subjects: ADL; intracerebral hemorrhage; long-term prognosis
• ISSN: 0912-0726; 1883-1923; 1883-1923
• DOI: 10.3995/jstroke.22.663

The present study inventigated the long-term prognosis of patients with intracerebral hemorrhage (ICH). We also identified significant factors that influenced long-term clinical outcomes. Subjects were 763 consecutively hospitalized and conservatively treated patients with acute ICH between 1986 and 1996. Computed tomography determined the localization of the hematoma: putamen (n=250); thalamus (n=231); pons (n=100); cerebellum (n=58); subcortex (n=101) or other locations (n=23). Two hundred and thirty patients (30.1%) died during hospital stay. Long-term prognosis was assessed for the 533 surviving patients by questionnaires mailed one year and 5 years after the onset of stroke. Functional outcome was assessed by the patients' ability to walk in the 5 categories. Responses were obtained from 457 patients (85.7%) at one year and 400 patients (75.0%) at five years. One year and 5 years after the onset of stroke, 49.9% and 44.8% of patients could walk normally or inde-pendently, respectively. Patient age, location of the hematoma, and walking ability at discharge were found to be significant factors influencing long-term functional outcome of patients using multiple regression analysis. The influence of age was more prominent 5 years after stroke onset. A Kaplan-Meier curve revealed that patients with putaminal or pontine hemorrhage had a relatively good prognosis for life after discharge, although the mortality rate was high during the acute stage. The present results revealed that the long-term outcome of patients with ICH was influenced by age, localization of hematomas, and severity of functional impairment of walking at discharge.