ICH - Intracerebral Hemorrhage, Intracerebral Haemorrhage, Intracerebral Haemorrhage, Intraventricular, Spontaneous Intracerebral Hemorrhage
Conditions
Keywords
Spontaneous ICH, Primary ICH, IVH, stroke, neurointensive care, Withdrawal of life sustaining treatment, functional outcome, Neurocritical care, Prehospital
Brief summary
Spontaneous intracerebral hemorrhage (ICH) represents 10-15% of all strokes and is associated with high mortality and morbidity. Rapid identification and interventions, e.g. early implementation of care bundles, seem to be critical for improving outcome. Nonetheless, relatively little is known about the influence of acute physiological risk factors in the prehospital phase, although high prehospital blood pressure has been associated with worse outcome in mild to moderate ICH. Whether the same applies to severe ICH requiring neurointensive care is unclear and furthermore the prognostic impact of other physiological variables has received little attention. The aim of this study is to retrospectively investigate prehospital characteristics of severe ICH and whether physiological abnormalities are associated with functional outcome, mortality after six months, and early withdrawal of life sustaining treatment.
Detailed description
This study investigates the association between prehospital blood pressure, neurological deficits, glucose, hypoxia and outcome in patients admitted to the neurointensive care unit at Copenhagen University Hospital, Rigshospitalet, between 11-01-2016 and 10-01-2025. All data pertaining to the first 24 hours from admission to first hospital, baseline characteristics, comorbidities, decisions to withdraw care within 24 hours and functional outcome and mortality at six months were extracted from electronic medical journals, while prehospital data was extracted from the Danish National Prehospital Database and supplemented with scanned EMS records when available.
Interventions
None listed
Sponsors
Kirsten Moller
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Primary spontaneous ICH confirmed by CT imaging. * Admission to the neurointensive care unit at Rigshospitalet within the study period. * Available prehospital journal linked to the initial hospital admission.
Exclusion criteria
* Age below 18 * ICH secondary to trauma, vascular malformation, tumour, haemorrhagic transformation of ischaemic stroke, aneurysms, or central venous sinus thrombosis. * Initial admission without confirmed ICH. * Admissions from hospitals outside the Capital Region of Denmark or Region Zealand. * Pure intraventricular hemorrhage without parenchymal involvement as determined by a radiologist. * Intrahospital ICH. * Iatrogenic ICH
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional status at 6 months | Time Frame: From ictus onset of symptoms or last seen well to six months | Modified Rankin Scale, mRS, (0-6 where lower scores mean a better outcome), with favourable outcomes defined as mRS of 0-3 and unfavourable 4-6 |
| Mortality at 6 months | From ictus to six months | Percent |
| Early withdrawal of life sustaining treatment | First 24 hours from admission to primary hospital | Percent |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| In hospital death | From hospital admission at day 1 until any death date coinciding with hospital discharge, assessed up to 36 months | Percent |
| Length of stay | From hospital admission at day 1 to hospital discharge or in-hospital death, assessed up to 36 months | Days |
Countries
Denmark
Outcome results
None listed