Prognostic index of postoperative mortality for patients with primary intracerebral hemorrhage

Abstract

Introduction: Spontaneous intracerebral hematoma is the form of stroke with the highest mortality and morbidity rates. There is no consensus as to which patients benefit from surgical evacuation of the hematoma and, furthermore, postoperative mortality is high in most series. Objective: To create a prognostic index of postoperative mortality for patients with intracerebral hematoma treated by craniotomy and hematoma evacuation. Methods: An observational, prospective study of 116 patients with intracerebral hematoma treated surgically was carried out. Preoperative factors related to postoperative mortality were identified. The identified prognostic factors were combined in an index to estimate its predictive capacity, and this capacity was verified in a different sample. Results: Age ≥ 60 years, Glasgow Coma Scale score ≤ 10 points, and hematoma depth ≥ 1.25 cm are independent predictors of postoperative mortality. The area under the curve for the probability of dying calculated by the logistic regression model in the estimation sample was 0.953 (CI: 0.905-1.000). The proposed postoperative mortality prognostic index classifies patients as low, intermediate, high risk and very high risk of death. Conclusions: The proposed prognostic index correctly predicts postoperative mortality in patients with intracerebral hematoma treated by craniotomy and evacuation of the hematoma.

Keywords

• hematoma intracerebral
• mortalidad
• pronóstico.