Study on correlation between clinical features and prognosis of patients with severe hypertensive cerebral hemorrhage

  Objective  To investigate correlation between clinical features and prognosis of patients with severe hypertensive intracerebral hemorrhage (HICH) in emergency intensive care unit (EICU).

  Methods  Clinical data of 154 patients with severe HICH who underwent surgical treatment in EICU was retrospectively collected. According to grading of Glasgow Outcome Scale (GOS) score 3 months after discharge, these patients were divided into poor prognosis group (including patients with grading of GOS Ⅰ, Ⅱ and Ⅲ, n=74) and good prognosis group (including patients with grading of GOS Ⅳ and Ⅴ, n=80). The modified Graeb Scale (mGS) score was used to evaluate the severity of cerebral hemorrhage in patients, and the patient′s age, gender, surgical methods, ventricular drainage, obstructive hydrocephalus, cerebral herniation, midbrain aqueduct structure, and mean wave amplitude (MWA) on the first day after surgery and pressure response index (PRx) were collected. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to analyze the prognostic factors, and the effectiveness for predicting prognosis was evaluated by mGS, MWA, and PRx.

  Results  Multivariate Logistic regression analysis showed that age, brain herniation, hydrocephalus, MWA, PRx were independent influencing factors for prognosis (P < 0.05 or P < 0.01). ROC curve analysis showed that the combined application of mGS score, MWA, and PRx had better efficacy in predicting prognosis than one indicator alone.

  Conclusion  Patients′age, cerebral herniation, hydrocephalus, MWA, PRx are the prognostic influencing factors of patients with severe hypertensive cerebral hemorrhage. The combined application of mGS score, MWA and PRx can effectively predict the prognosis of patients with severe HICH.