Risk Factors For Early Death In Youth With Intracerebral Hemorrhage

Background and ObjectivesIntracerebral hemorrhage, also known as spontaneous intracerebral hemorrhage, refers to primary and non-traumatic brain parenchymal hemorrhage, which is generally considered as the most destructive form of stroke with high mortality; the survivors usually leave serious sequelae due to the secondary neurological injuries of perihematoma after intracerebral hemorrhage. With the improvement of living standard and increase of work and life stress, the incidence of intracerebral hemorrhage shows a younger tendency. Intracerebral hemorrhage in youth [2] is characterized by acute onset, severe condition, quick change, high disability and fatality rate, bring heavy burden to social economy and family. This study is mainly aimed to explore the risk factors that affect early death(within 30 days) in youth with intracerebral hemorrhage in order to provide early intervention and treatment, reducing mortality and improving clinical prognosis. Subjects and MethodsWe retrospectively reviewed case data of died youth with intracerebral hemorrhage treated in Tianjin Huanhu Hospital from June 2005 to June 2015. The clinical baseline data of 196 cases that met the requirements was carefully recorded in accordance with the listed contents of survey, and the cases were divided into the corresponding groups according to different factors to carry on the survival analysis of the median survival time, 10 days and 20 days. Kaplan-Meier method was used for calculating the patient's survival rate, Log-rank was used for significance test of survival rate, and COX proportional hazard regression model was used for univariate and multivariate analysis in order to evaluate the effect of different factors on youth early death. ResultsUnivariate analysis: age, heavy physical labor, disturbance of consciousness, NIHSS and GCS score, epilepsy, hernia, infratentorial hemorrhage, ventricular dilatation, blood glucose, leukocytes, fibrinogen, albumin, creatinine and uric acid showed statistically significant difference(P <0.05), which were the factors affecting early death in youth with intracerebral hemorrhage. The COX multivariate regression analysis showed that disturbance of consciousness, hematoma position, epilepsy and albumin were independent risk factors for early death in youth with intracerebral hemorrhage. Conclusions: 1. Among the youth with intracerebral hemorrhage, the incidence of male patients was higher than that of female patients. The age of onset was converged on 36 to 45 years old. 2. For the patients with intracerebral hemorrhage who are ranged from 16 to 25 years old, the survival time is shortest and mortality risk is highest; sex is not the independent risk factor of early death. There is no sex difference on 30 days' mortality risk. 3. Age, heavy physical labor, NIHSS and GCS score, ventricular dilatation, blood glucose, leukocytes, fibrinogen, creatinine and uric acid were the factors associated with the prognosis of the youth with intracerebral hemorrhage. 4. Disturbance of consciousness, hematoma position, epilepsy and albumin were independent risk factors for early death in youth with intracerebral hemorrhage. If disturbance of consciousness, infratentorial hemorrhage, early onset of epilepsy and hypoalbuminemia occur in the early time after intracerebral hemorrhage, the risk of early death in youth with intracerebral hemorrhage will increase. 5. Timely examination and effective intervention on the relative risk factor for early death in youth patient with intracerebral hemorrhage was of importance to improve the prognosis of the youth with intracerebral hemorrhage.