The Risk Factors Of Cerebral Hemorrhage In Youth And Middle-aged And Old Patients And Its Relationship With The Prognosis

Objective: To investigate the risk factors of cerebral hemorrhagic in youthmiddle-aged and old patients and its relationship with the prognosis.Materials and methods:1.We prospectively registered consecutive casesof348patients with acute spontaneous cerebral hemorrhagic at theneurosurgery neurology、Neurosurgery and rehabilitation wards of theSichuan Provincial People’s Hospital from June01,2012to November30,2013.Patients who met the diagnostic criteria for adult spontaneous cerebralhemorrhage treatment guidelines in2010were included. Dynamic observedpatient’s condition during hospitalization. And all the relevant clinic andlaboratory examination dates which influencing spontaneous cerebralhemorrhage were collected.2. All registered cerebral hemorrhage patientswere divided into young group <45years old and middle/old aged group≥45years old.3.Following up at the end of3month and6month afterpatient’s symptom onset, got the information about prognosis:The maincontents of the follow-up visits included:1). Survival state.2). Strokerecurrence state.3). Medication state.4). Disability state. Disability wasjudged by Modified Rankin Scale (MRS), MRS≥3points was defined todisability(The total of death and disability), MRS＜3points was defined tonon-disability. The main effect index：（1）The final follow-up mortality；2）The rate of adverse outcomes(death/disability) at end of the follow-up；4.Using SPSS17.0software package for data for statistical analysis,measurement data were expressed as Mean±SD or median. Differencesamong groups were analyzed by Student t test when the data meet normal distribution. If the dates meet non-normal distribution, rank sum test wereused. Qualitative data were analyzed using Chi-square (χ2) test. When fourappear in the table (theoretical frequency, T＜5), Using four table exactprobability method.5. Influencing factors about death/disability (death)when patient’s symptom onset3month and6month, were analyzed byusing univariate analysis. When univariate analyses show P≤0.10,multivariate logistical regression was utilized to detect the independentimpact factors of death/disability (death) when patient’s symptom onset3month and6month, and identify independent risk factors affecting theprognosis.Result:1.308cases were included, which46patients (14.9%) were younggroup, and262patients (85.1%) were the middle and old aged group. Theage range of the young group was21-44years old (38.8±7.1),36caseswere male (78.3%),10cases were female (21.7%). The age range of themiddle and old aged group was45-90years old (66.6±11.5),165caseswere male (63.0%),97cases were female (37.0%). In both group, theincidence were higher in male(X2test, P <0.05),2. There were2personsdied of in the youth group during hospitalization (8.7%), the bleeding placemainly in the brain stem and multifocal. There were28persons died ofcerebral hemorrhage in the middle and old aged group duringhospitalization (10.7%), the bleeding place mainly in the brain stem, basalganglia, thalamus and multifocal.3. Hypertension was the most importantrisk factors in two groups of patients with cerebral hemorrhage. Diabetesand hyperlipidemia were major risk factors in the middle and old agedgroup of cerebral hemorrhage. The main risk factors for intracerebralhemorrhage in young patients were drinking alcohol, smoking andcerebrovascular malformation. There were significant statistical differenceexisted about gender, history of diabetes, hypertension and stroke in bothgroup, during the two groups of patients in hospital death/disability and non-disabled difference between statistical significance.4. The independentpredictor of death in the end of3month and6month was the severity ofdisease on admission (the NIHSS).5. Groups and NIHSS score were theindependent risk factors of death/disability in patients in the end of3monthand6month. The blood glucose on admission was the independent riskfactor for death/disability in patients in the end of6month.Conclusion:1.Control blood pressure can decrease the incidence ofspontaneous intracerebral hemorrhage in both group. It is important tocontrol diabetes and hyperlipidemia in the middle and old aged group andsmoking cessation and limiting drinking for young people.2. Thehemorrhage which occured in the brain stem had a high mortality，occur inthe brain stem and thalamus of patients with poor prognosis.3. The elderlyaged45years of age or older, and the higher of blood glucose on admission,the more severity of neurofunction deficiency and the more reliability tohave the bad outcome (death/dependency).