RESUMEN
Cerebral hemorrhages are subject to a heavy short- and long-term case fatality. A study of prognostic factors and of relative survival based on the data of a population registry is of great value to study patients having a hematoma of all ages, irrespective of the method of care. We have listed 183 patients having a cerebral hemorrhage between 1 January 1985 and 31 December 1996 and living in the city of Dijon, France. Eighteen clinical and CT-scanning variables have been studied. We have found four predictive factors of death at one month from cerebral hemorrhages. These are, in decreasing order: the existence of consciousness disorders at the initial clinical examination (OR = 5.80, p < 0.0001); an intraventricular hemorrhage (OR = 5.60, p < 0.0001); a hematoma volume over 11 cubic centimeters (OR = 3.53, p = 0.027); lastly, in male patients an age over 70 years (OR = 4.90, p = 0.039). With regard to long-term survival, the existence of consciousness disorders remains the principal predictive factor of case fatality in both crude and relative survival (OR = 5.52, p < 0.0001, in crude survival versus OR = 22.2 in relative survival, p < 0.0001), followed by age over 70 years (OR = 3.71, p < 0.0001 in crude survival and OR = 2.41 in relative survival, p = 0.086). The existence of consciousness disorders at the initial examination following a cerebral hemorrhage would seem to be the principal worst prognostic factor of short- and long-term survival and of relative survival, age and sex having less importance. Moreover, intraventricular hemorrhage and hematoma volume are short-term, pejorative factors. These data, based on a population-based registry, are an important consideration in the acute management of hemorrhagic therapy, and for the design of further therapeutic trials on this severe pathology.