Clinical features and outcomes of intracerebral hemorrhage induced by coagulation dysfunction: analysis of 134 cases

Abstract

Objective To analyze the clinical characteristics and outcomes of intracerebral hemorrhage induced by coagulation dysfunction and explore its optimal interventions. Methods From January 2000 to August 2016, a total of 134 patients with cerebral hemorrhage caused by coagulation dysfunction were admitted in our department. The types of coagulation disorders, interventions, mortality, modified Rankin Scale (mRS) scores at discharge, and perioperative complications (hematoma enlargement, pulmonary infection, hydrocephalus, alimentary tract hemorrhage, and deep venous thrombosis) were analyzed in these patients. Results The prognosis of the patients was evaluated based on mRS scores at discharge. Among the 134 patients, 54 died (mRS score of 6), 47 had severe disabilities (mRS scores of 3~5), and 33 had favorable prognoses (mRS scores of 1~2). The patients with intracerebral hemorrhage associated with the use of warfalin and hematologic disease had the worst prognosis with a mortality rate above 50%. In the patients with a hemorrhage volume of >30~80 mL, 32 received conservative treatment and 36 underwent surgical interventions, and the mortality rate was significantly higher in the patients with conservative treatment than those undergoing surgical treatment (71.9% vs 44.4%, P < 0.05); the average length of hospital stay was also significantly longer in the conservative treatment group than in the surgical group (20.09±5.35 vs 17.02±5.90 d, P < 0.05). Conclusion The patients with intracerebral hemorrhage caused by coagulation dysfunction have poorer outcomes than those with hypertensive intracerebral hemorrhage. Early and effective interventions of coagulation dysfunction, close monitoring of potential complications and early surgical intervention can improve the outcomes of patients with large intracerebral hematoma.

Keywords

• coagulation dysfunction
• intracerebral hemorrhage
• surgery