Predictors of functional outcome of spontaneous intracerebral hemorrhage in elderly patients from a comprehensive stroke care unit, prospective cohort hospital based study

Abstract

INTRODUCTION: Few studies have been reported on intracerebral Hemorrhage (ICH) in elderly patients at Middle East and North Africa region (MENA). It is thought that epidemiological, radiological characteristics, and neurological outcomes differ in elderly patients from younger age group. Our study's aim is detection of the difference between them as regard clinical and radiological characters, functional outcome, and its predictors. METHODS: All patients with spontaneous ICH were divided into two groups, elderly group (≥ 70 years old) and younger age group. All clinical and-radiological data were collected. The patients were classified into four categories (probable Cerebral Amyloid Angiopathy, Hypertensive, Vascular and Undetermined). One-month mortality and three months' functional outcome, using modified Rankin Scale (mRS). were determined. Multivariate logistic regression was performed to determine the predictors of favorable functional outcome. RESULTS: Prospective cohort study was conducted on 71 old age patients from 238 patients (30.3%). Hypertension, higher NIHSS (National Institutes of Health Stroke Scale) lower GCS (Glasgow Coma Scale) and previous medications of antiplatelet or anticoagulant were more common in elderly group with statistically significant difference (P value: < 0.017, 0.002, 0.002, and 0.003, respectively). Probability of CAA (Cerebral Amyloid Angiopathy) was common in elderly patients. Younger age group had better outcome as regard three months' functional outcome and one-month mortality (44.3% versus 19.7% with p value: < 0.001, 21.6% versus 39.4% with p value: 0.006, respectively). GCS and NIHSS are predictors of favorable functional outcome. CONCLUSION: Spontaneous ICH in elderly has different demographic, clinical and radiological findings with worse One-month mortality and functional outcome. Higher GCS and lower NIHSS are predictors of favorable functional outcome.