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Is nontraumatic intracerebral hemorrhage different between young and elderly patients?

Title
Is nontraumatic intracerebral hemorrhage different between young and elderly patients?
Authors
Yang, Na RaeKim, Ji HeeAhn, Jun HyongOh, Jae KeunChang, In BokSong, Joon Ho
Ewha Authors
양나래
Issue Date
2020
Journal Title
NEUROSURGICAL REVIEW
ISSN
0344-5607JCR Link

1437-2320JCR Link
Citation
NEUROSURGICAL REVIEW vol. 43, no. 2, pp. 781 - 791
Keywords
Intracerebral hemorrhageMortalityOutcomePredictorRisk factorYoung patients
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Only a few studies have reported nontraumatic intracerebral hemorrhage in young patients notwithstanding its fatal and devastating characteristics. This study investigated the clinical characteristics and outcome of nontraumatic intracerebral hemorrhage in young patients in comparison to those of the elderly. A retrospective review of consecutive patients admitted at the department of neurosurgery of two tertiary care medical centers presenting with first-ever nontraumatic intracerebral hemorrhage was performed. We identified and compared the demographics, etiologies, risk factors, and laboratory, radiological, and clinical findings between elderly and young patients. Additionally, logistic regression analyses of independent prognostic factors associated with 1-month mortality and favorable functional outcome were performed. Altogether, 247 patients including 69 young patients and 178 elderly patients were enrolled. On multivariate analysis, young patients exhibited significantly more often an infratentorial hematoma location, excessive alcohol consumption, and high body mass index (BMI), but less frequent systemic hypertension. There was no statistical difference between the two groups in 1-month mortality (17.46% and 18.01% for young and elderly patients, respectively), but the favorable functional outcome based on modified Rankin scale score of 0 or 1 was significantly different between the two groups (favorable outcome in 51.79% and 29.93% of patients, respectively). Predictors of 1-month mortality was the presence of herniation in the young group, and lower Glasgow Coma Scale score, renal or heart disease, and leukocytosis (WBC > 10,000) in the elderly group. Lower National Institutes Health Stroke Scale score was associated with favorable functional outcome in both groups. Nontraumatic intracerebral hemorrhage in younger patients appears to be associated with excessive alcohol consumption and high BMI. Younger patients had similar short-term mortality but more favorable functional outcome than the elderly.
DOI
10.1007/s10143-019-01120-5
Appears in Collections:
의과대학 > 의학과 > Journal papers
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