Impact Of Pre-Hospital Time On Short-Term Outcome Of Patients With Spontaneous Intracerebral Hemorrhage

Objectives Patients with spontaneous intracerebral hemorrhage(SICH)are more rapidly progressive and often deteriorate within the first few hours after onset.Higher risk of neurological deterioration,emphasizing the necessity for early treatment.But we know too little about the effect of pre-hospital time on the short-term outcome of patients with SICH.Therefore,this study sought to analyze the impact of pre-hospital time on the short-term outcome of patients with SICH.Methods In this study,Excel software was used to collect in detail the data of patients diagnosed with SICH from January 2015 to December 2020 in the Affiliated Hospital of North China University of science and technology,and an investigational database was established to conduct a retrospective cohort study.All included data were analyzed by SPSS v22.0 and R v3.3.3,and all variables with P<0.1 were selected by univariate analysis.The association between pre-hospital time and in-hospital death in patients with SICH was further analyzed by logistic regression with separate adjustment for different suspected confounders in the model.Results Univariate analysis showed that smoking,drinking,personal history of cerebral hemorrhage / stroke,systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),white blood cell(WBC),D-dimer(DD),aspartate transferase(AST),total cholesterol(TC),lactate dehydrogenase(LDH),creatinine,glucose,hematoma volume,intraventricular hemorrhage(IVH),pre-hospital time less than 6 hours,bleeding site,Glasgow coma score(GCS)and low density lipoprotein(LDL),these factors,differed significantly between the in-hospital death group and the in-hospital survival group.Through the Logistic regression,a simple association between pre-hospital time less than 6hours and hospital mortality in patients with SICH was made to model 1(OR=4.047,95%CI:2.066-7.926,β=1.398,P<0.001),indicating that pre-hospital time less than 6 hours may be a risk factor for in-hospital mortality in patients with SICH.After adjusting for confounding,all suspected confounders identified in univariate analysis were adjusted(OR=2.345,95%CI:1.072-5.130,β=0.852,P=0.033<0.05),indicating that pre-hospital time less than 6 hours may be an independent risk factor for in-hospital mortality in patients with SICH,and hematoma volume,intraventricular hemorrhage,location of hemorrhage,and Glasgow coma score(GCS)these suspected confounders were potential confounders for pre-hospital time less than 6 hours.Further,we fit the factors of prehospital time,hematoma volume,intraventricular hemorrhage,hemorrhage location,and Glasgow coma score(GCS)into a pre-diction model for in-hospital death in SICH and further demonstrated that pre-hospital time less than 6 hours was an independent risk factor for in-hospital death in patients with SICH,and evaluated the model value by the area under the receiver operating characteristic(ROC)curve(AUC=0.8695),Indicating that the resulting model has a good discrimination ability.Conclusions Pre-hospital time less than 6 hours seems to be an independent risk factor for in-hospital mortality in patients with SICH.It can be combined with these potential confounding factor of hematoma volume,intraventricular hemorrhage,bleeding site and Glasgow coma score(GCS)to predict the probability of in-hospital mortality in patients with SICH.The impact of specific pre-hospital time on patients’ in-hospital death still needs further exploration.Moreover,these results need to be interpreted with caution because this study was retrospective.Figure5;Table3;Reference 121...