Early Neurological Deterioration And Its Association With Poor Functional Outcome After Basal Ganglia Hemorrhage

Part I:The predictive value of serum C-reactive protein for early neurological deterioration in basal ganglia hemorrhageObjective To evaluate the relationship between serum C-reactive protein(CRP) with early neurological deterioration (END) in basal ganglia hemorrhage.Methods From Sep 2012 to Sep 2014,101 patients with cerebral hemorrhage in basal ganglia were prospectively enrolled. END was diagnosed when the Canadian Stroke Scale (CSS) score decreased1 or more points during the 48 hours after the inclusion. Associated factors and predictive value of serum CRP concentration for END in patients with basal ganglia hemorrhage were analyzed by logistic regression and ROC curve.Results The number of patients with END was 29 (28.7%). Patients with END had lower CSS score at admission, but they showed higher levels of CRP, leukocyte counts, hematoma volume and prevalence of intraventricular hemorrhage (P< 0.05). Logistic regression analysis indicated that CRP levels (OR=1.088,95%CI 1.032-1.151, P=0.003), intraventricular hemorrhage (OR=4.104,95%CI 1.168-14.416, P=0.028) and leukocyte counts (OR=1.297,95%CI 1.035-1.627, P =0.024) were associated with END in basal ganglia hemorrhage.Conclusion END was more prone to occur in patients with elevated CRP levels, which may be helpful in predicting patients with END in basal ganglia hemorrhage. counts, hematoma volume and prevalence of intraventricular hemorrhage (P< 0.05). Logistic regression analysis indicated that CRP levels (OR=1.088,95%CI 1.032-1.151, P=0.003), intraventricular hemorrhage (OR=4.104,95%CI 1.168-14.416, P=0.028) and leukocyte counts (OR=1.297,95%CI 1.035-1.627, P =0.024) were associated with END in basal ganglia hemorrhage.Conclusion END was more prone to occur in patients with elevated CRP levels, which may be helpful in predicting patients with END in basal ganglia hemorrhage.Part II:Impact of early neurological deterioration on functional outcome after basal ganglia hemorrhageObjective To investigate impact of early neurological deterioration on functional outcome after basal ganglia hemorrhageMethods Eighty-seven patients with cerebral hemorrhage in basal ganglia were prospectively enrolled between Sep 2012 and Sep 2014. END was diagnosed when the Canadian Stroke Scale (CSS) score decreased1 or more points during the 48 hours after the inclusion. Functional outcomes were assessed using the modified Rankin Scale (mRS) at 3 months, and divided into poor (mRS 4-6) and good (mRS 0-3) group. The influence of END on functional outcome after basal ganglia hemorrhage were analyzed by logistic regression.Results END was found in 23 (26.4%) patients. Patients with END were more prone to occur unfavorable outcome as compare to without END. Logistic regression analysis indicated that END (OR=2.984,95%CI:1.036-8.594, P= 0.043) was predictor of poor outcome at 3 months after adjusted for age and sex.Conclusion Patients occurred END at hospital was more prone to obtain an unfavorable functional outcome in basal ganglia hemorrhage.