CT imaging for long-term functional outcome after spontaneous intracerebral haemorrhage: A 3-year follow-up study.

PRIMARY OBJECTIVE

To define the prognostic value of head computed tomography (CT) in patients suffering from SICH after 3 years of follow-up.

RESEARCH DESIGN AND METHODS

Between January 2011 and May 2012, consecutive patients with SICH who underwent brain CT scans within the first 12 hours of presentation were prospectively included. Independent predictors of 30-day mortality and unfavourable functional outcome (modified Rankin Scale = 4-6 and Barthel Index ≤ 60) at 36 months were identified by univariable and multivariable regression analysis.

MAIN OUTCOMES AND RESULTS

A total of 228 participants were identified. According to multivariable analysis, independent CT-related predictors for 30-day mortality were intraventricular haemorrhage [IVH] (OR = 2.42; p = 0.009), haematoma volume ≥ 30 cm (OR = 3.32; p = 0.006), the presence of midline shift (OR = 3.77; p = 0.004) and hydrocephalus (OR = 5.22; p = 0.001). Further, IVH (OR = 3.72, 95% CI = 1.16-11.8, p = 0.026), volume of haemorrhage ≥ 30 cm (OR = 3.96; 95% CI = 1.65-5.84; p = 0.015) and midline shift (OR = 6.58; 95% CI = 1.33-32.4; p = 0.021) had significant associations with an mRS ≥ 4 at 36 months.

CONCLUSIONS

A favourable long-term functional outcome at 36 months and short-term survival were less likely in patients with greater volume of haematoma, presence of IVH and midline displacement.