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J Stroke Cerebrovasc Dis ; 29(11): 105242, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33066927

ABSTRACT

BACKGROUND: There is geographic variability in the clinical profile and outcomes of non-traumatic intracerebral hematoma (ICH) in the young, and data for the Philippines is lacking. We aimed to describe this in a cohort from the Philippines, and identify predictors of mortality. METHODS: We performed a retrospective study of all patients aged 19-49 years with radiographic evidence of non-traumatic ICH admitted in our institution over five years. Data on demographics, risk factors, imaging, etiologies, surgical management, in-hospital mortality, and discharge functional outcomes were collected. Multivariate logistic regression analysis was done to determine factors predictive of mortality. RESULTS: A total of 185 patients were included, which had a mean age of 40.98 years and a male predilection (71.9%). The most common hematoma location was subcortical, but it was lobar for the subgroup of patients aged 19-29 years. Overall, the most common etiology was hypertension (73.0%), especially in patients aged 40-49. Conversely, the incidence of vascular lesions and thrombocytopenia was higher in patients aged 19-29. Surgery was done in 7.0% of patients. The rates of mortality and favorable functional outcome at discharge were 8.7% and 35.1%, respectively. Younger age (p = 0.004), higher NIHSS score on admission (p=0.01), higher capillary blood glucose on admission (p=0.02), and intraventricular extension of hematoma (p = 0.01) predicted mortality. CONCLUSIONS: In the Philippines, the most common etiology of ICH in young patients was hypertension, while aneurysms and AVM's were the most common etiology in the subgroup aged 19 - 29 years. Independent predictors of mortality were identified.


Subject(s)
Cerebral Hemorrhage/epidemiology , Hematoma/epidemiology , Hypertension/epidemiology , Intracranial Aneurysm/epidemiology , Intracranial Arteriovenous Malformations/epidemiology , Adult , Age Distribution , Cerebral Hemorrhage/diagnostic imaging , Cerebral Hemorrhage/mortality , Cerebral Hemorrhage/surgery , Female , Hematoma/diagnostic imaging , Hematoma/mortality , Hematoma/surgery , Humans , Hypertension/diagnosis , Hypertension/mortality , Incidence , Intracranial Aneurysm/diagnostic imaging , Intracranial Aneurysm/mortality , Intracranial Aneurysm/surgery , Intracranial Arteriovenous Malformations/diagnostic imaging , Intracranial Arteriovenous Malformations/mortality , Intracranial Arteriovenous Malformations/surgery , Male , Middle Aged , Philippines/epidemiology , Prognosis , Retrospective Studies , Risk Factors , Tertiary Care Centers , Young Adult
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