Prognostic Indicators in Patients with Intracerebral Hematoma in an Urban Clinical Setting of a Resource Limited Country.

Introduction: Hemorrhagic Cerebrovascular Accident represents 10 to 15% of all strokes and are often related to the spontaneous rupture of small vessels weakened by chronic arterial hypertension, amyloid angiopathy, tumor bleed, arteriovenous malformation (AVM), and coagulopathies. The aim of this study was to determine probable prognostic indicators in functional outcomes of patient with ICH. Materials and Methods: This was a retrospective analytical study of patients (men and women, of all ages) who were hospitalized at the Neurology Department of the University Hospital of Conakry for an intracerebral hematoma over the 24-month period. Only the records of patients in whom intracerebral hematoma was confirmed by brain imaging were included in this study. The variables studied were epidemiological, clinical, and para-clinical. Therapeutic, evolutionary and prognostic variables were also taken into account. Logistic regression (univariate and multivariate) was used to identify the prognostic determinants of intracerebral hematomas at p < 0.05. Data were entered using Epi Info software version 7.1.4.0 and then analyzed using STATA/SE software version 11.2. Results: We collected 105 cases of spontaneous cerebral hematomas confirmed by brain imaging out of 491 patients with stroke (21%). There was a male predominance of 60%. Arterial hypertension was identified as the cause in 94 patients (89.52%), followed by arteriovenous malformations in 6.67%, 2.86% amyloid angiopathy and 0.95% of unknown cause. During the hospitalization of the patients, we recorded 20% of deaths. Poor prognosis was associated with length of stay for > 10 days (p=0.001), hematoma volume (p=0.02), GCS <7 (p=0.001) and high ICH score (p=0.0001). Conclusion: Premorbid physical condition and comorbidities affects the prognostic course in patient with ICH and should be taken into account in the prediction of disability and future quality of life. [ABSTRACT FROM AUTHOR]