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J Stroke Cerebrovasc Dis ; 29(11): 105242, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066927

RESUMO

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.


Assuntos
Hemorragia Cerebral/epidemiologia , Hematoma/epidemiologia , Hipertensão/epidemiologia , Aneurisma Intracraniano/epidemiologia , Malformações Arteriovenosas Intracranianas/epidemiologia , Adulto , Distribuição por Idade , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral/mortalidade , Hemorragia Cerebral/cirurgia , Feminino , Hematoma/diagnóstico por imagem , Hematoma/mortalidade , Hematoma/cirurgia , Humanos , Hipertensão/diagnóstico , Hipertensão/mortalidade , Incidência , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/mortalidade , Aneurisma Intracraniano/cirurgia , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/mortalidade , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Filipinas/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Adulto Jovem
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