Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage



Título del documento: Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage
Revista: Revista de investigación clínica
Base de datos: PERIÓDICA
Número de sistema: 000452985
ISSN: 0034-8376
Autores: 1
3
4
2
5
1
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6
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4
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Instituciones: 1Hospital Civil de Guadalajara Fray Antonio Alcalde, Departamento de Neurología, Guadalajara, Jalisco. México
2Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco. México
3Universidad Autónoma de Sinaloa, Departamento de Medicina, Culiacán, Sinaloa. México
4Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Departamento de Neurología y Psiquiatría, Ciudad de México. México
5Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco. México
6Hospital H+, Departamento de Neurología, Querétaro. México
7Universidad Autónoma de Guadalajara, Facultad de Medicina, Guadalajara, Jalisco. México
8Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Clínica de Accidentes Cerebrovasculares, Ciudad de México. México
Año:
Periodo: Ene-Feb
Volumen: 74
Número: 1
Paginación: 51-60
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Background: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation. Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome. Methods: In this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied. Clinical data, arrival conditions, and prognostic scores were analyzed. Multivariate models were built to find independent predictors of < 6 h arrival (logistic regression) and in-hospital death (Cox proportional-hazards model). Results: Among the 473 patients analyzed (51% women, median age 63 years), the median delay since onset to admission was 6.25 h (interquartile range: 2.5-24 h); 7.8% arrived in < 1 h, 26.3% in < 3 h, 45.3% in < 6 h, and 62.3% in < 12 h. The in-hospital, 30-day and 90-day case fatality rates were 28.8%, 30.0%, and 32.6%, respectively. Predictors of arrival in < 6 h were hypertension treatment (odds ratios [OR]: 1.675, 95% confidence intervals [CI]: 1.030-2.724), ≥ 3 years of schooling (OR: 1.804, 95% CI: 1.055-3.084), and seizures at ICH onset (OR: 2.416, 95% CI: 1.068-5.465). Predictors of death (56.9% neurological) were systolic blood pressure > 180 mmHg (hazards ratios [HR]: 1.839, 95% CI: 1.031-3.281), ICH score ≥ 3 (HR: 2.302, 95% CI: 1.300-4.074), and admission Glasgow Coma Scale < 8 (HR: 4.497, 95% CI: 2.466-8.199). Early arrival was not associated with outcome at discharge, 30 or 90 days. Conclusions: In this study, less than half of patients with ICH arrived to the hospital in < 6 h. However, early arrival was not associated with the short-term outcome in this data set
Disciplinas: Medicina
Palabras clave: Sistema cardiovascular,
Neurología,
Hospitales,
Accidentes cerebrovasculares,
Ingreso hospitalario,
Hemorragia intracerebral,
Mortalidad
Keyword: Cardiovascular system,
Neurology,
Hospitals,
Stroke,
Hospital admission,
Intracerebral hemorrhage,
Mortality
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