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The prognostic value of the CT scan in Primary Intracerebral Haemorrhage

Rathor, Mohammad Yousuf and Abdul Rani, Mohammed Fauzi and Ab Rahman, Jamalludin and Abdul Rashid, Mohd Amran and Che Abdullah, Shahrin Tarmizi (2012) The prognostic value of the CT scan in Primary Intracerebral Haemorrhage. In: IIUM Research, Invention and Innovation Exhibition 2012, 20-22 February 2012, CAC IIUM Gombak. (Unpublished)

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Abstract

Background: Primary intracerebral hemorrhage (PICH) remains the deadliest and most disabling form of stroke. There is no therapy of proven benefit in improving outcome. Objective: To evaluate the use of the computerized tomography (CT) scans as a predictor of in- hospital survival and neurological recovery after PICH. Methods: A prospective study conducted among PICH patients at a tertiary care level hospital. Their clinical and CT scan findings were correlated with the clinical outcome using modified Rankin scores (mRS) of 0-5 at discharge and during 6 months follow-up. For the assessment of functional status, the mRS was contracted into independent (Grade 0 to 2) and dependent (Grade 3 and above) categories. Results: A total of 160 (93 male and 67 female) eligible patients with age range from 25 to 85 years (mean age 58.30 ± 11.44 years) were evaluated. The overall mortality was 32.5 %. About one third (32.7%) of the deaths occurred within first 24 hours, this rose to 38.5% within first 2 days and 84.6% within one week. The mean Glasgow Coma Scale [GCS] score was significantly higher among survivors. (12.8 ± 0.4 vs. 8.5 ± 0.5, p < 0.001) Lobar ICH was the commonest localization (43.8%), followed by basal ganglia / thalamus (28.1 %) and multilobar (13.1%). The best outcome in terms of survival was for the patients with ICH in basal ganglia / thalamus region (86.7 %), followed by lobar (67.1%). Mean ICH volume was significantly higher among the dead than the survivors (65.60 + 36.6 ml vs. 32.30 + 18.3 ml). Good functional outcome was associated with a hematoma volume of less than 30 ml. At discharge majority of the survivors were functionally dependent 76 (70.4%) and only 32 (29.6%) achieved functional independence. After about 6 months follow-up, 5 patients were lost due to default in treatment and invalid telephone number, 69 (84.1%) were independent and 13 (15.9%) were still dependant. The independent significant predictors of acute in- hospital survival were locations of hematoma and hematoma volume. Conclusions: Outcome and functional status at discharge were well correlated with the initial CT scan findings and therefore CT scan is a useful tool in clinical decision making and prognostication.

Item Type: Conference or Workshop Item (Poster)
Additional Information: 2309/ 27671
Uncontrolled Keywords: Primary intracerebral haemorrhage, CT scan, Modified Rankin Score, Glasgow coma Scale, Survival
Subjects: R Medicine > RC Internal medicine
Kulliyyahs/Centres/Divisions/Institutes: Kulliyyah of Medicine > Department of Community Medicine (Effective: 1st January 2011)
Kulliyyah of Medicine > Department of Internal Medicine
Kulliyyah of Medicine > Department of Radiology
Depositing User: Professor Dr Mohammad Yousuf Rathor
Date Deposited: 19 Dec 2012 15:18
Last Modified: 10 Mar 2016 15:10
URI: http://irep.iium.edu.my/id/eprint/27671

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