Analysis Of Correlative Factors Of Hematoma Enlargement And Prognosis In Intracerebral Hemorrhage

Objective To analyze the clinical data of patients with supratentorial intracerebralhemorrhage, to explore the incidence, correlative factors and prognosis of hematomaenlargement in intracerebral hemorrhage, in order to develop appropriate clinicalcountermeasures.Methods①The object of the study is from patients with supratentorial intracerebral hemorrhagetreated at Department of Neurology, Lu’an People’s Hospital from January2007toDecember2011.196cases that met the inclusion criteria were divided into twogroups-hematoma enlargement group and non-hematoma enlargement groupaccording to another CT scan. We discuss the rate of enlargement of hemorrhageand compare clinical characteristics and dynamic brain CT data within24hoursafter onset between the groups.②We use the modified Rankin Scale (mRS) to evaluate the recovery of neurologicalfunction of patients at the end of the third week and record the score and thencompare the characteristics between the patients whose mRS score＞3and patientswhose mRS score≤3.Results The early enlargement of cerebral hemorrhage accounted for38.78%of thisgroup (76/196).The detection rate of hematoma enlargement in patient arriving in3hours after onset was higher than that in3-6hours according the brain CT within24hours after admission, the difference was statistically significant (P=0.022). Thedifferences of systolic blood pressure, diastolic blood pressure, disturbance ofconsciousness on admission, fasting glucose levels on later morning, and pre-hospital long-term history of alcohol consumption between the two groups was statisticallysignificant in univariate analysis. P value was0.017,0.036,0.047,0.010and0.033,respectively. With systolic or diastolic blood pressure levels elevated, the rate ofhematoma enlargement increased. The probability of hematoma enlargement in patientswith increased fasting blood glucose is higher than patients with normal fasting bloodglucose. Multivariate analysis displayed that systolic blood pressure on admission,fasting glucose levels on later morning and long-term alcohol consumption wereindependently associated with hematoma enlargement. P values was0.045,0.014,0.037respectively, OR values was1.013(1.000,1.025),1.213(1.041,1.415),2.216(1.047,4.319) respectively. There were a total of132cases with mRS score＞3points at theend of the third week, accounting for67.35%.Hematoma enlargement is an independentrisk factor for poor prognosis (P=0.016, OR=2.823(1.218,6.542)).In addition,hematoma volume, state of consciousness and NIHSS score on admission wereindependently associated with short-term poor prognosis.Conclusion The incidence of hematoma enlargement is high. Elevated systolic pressureafter admission, fasting glucose levels on later morning and long-term alcoholconsumption may be the risk factors of hematoma enlargement. Hematoma enlargementmay be one of the main factors determined the prognosis.