Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis
Abstract Background Cerebellar hemorrhage is a potentially life-threatening condition and neurologic deterioration during hospitalization could lead to severe disability and poor outcome. Finds out the factors influencing neurologic deterioration during hospitalization is essential for clinical deci...
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-019-1312-8 |
| _version_ | 1818352887732895744 |
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| author | Yu-Ni Ho Shih-Yuan Hsu Yu-Tsai Lin Fu-Chang Cheng Yu-Jun Lin Nai-Wen Tsai Cheng-Hsien Lu Hung-Chen Wang |
| author_facet | Yu-Ni Ho Shih-Yuan Hsu Yu-Tsai Lin Fu-Chang Cheng Yu-Jun Lin Nai-Wen Tsai Cheng-Hsien Lu Hung-Chen Wang |
| author_sort | Yu-Ni Ho |
| collection | DOAJ |
| description | Abstract Background Cerebellar hemorrhage is a potentially life-threatening condition and neurologic deterioration during hospitalization could lead to severe disability and poor outcome. Finds out the factors influencing neurologic deterioration during hospitalization is essential for clinical decision-making. Methods One hundred fifty-five consecutive patients who suffered a first spontaneous cerebellar hemorrhage (SCH) were evaluated in this 10-year retrospective study. This study aimed to identify potential clinical, radiological and clinical scales risk factors for neurologic deterioration during hospitalization and outcome at discharge. Results Neurologic deterioration during hospitalization developed in 17.4% (27/155) of the patient cohort. Obliteration of basal cistern (p≦0.001) and hydrocephalus (p≦0.001) on initial brain computed tomography (CT), median Glasgow Coma Scale (GCS) score at presentation (p≦0.001) and median intracerebral hemorrhage (ICH) score (P≦0.001) on admission were significant factors associated with neurologic deterioration. Stepwise logistic regression analysis showed that patients with obliteration of basal cistern on initial brain CT scan had an odds ratio (OR) of 9.17 (p = 0.002; 95% confidence interval (CI): 0.026 to 0.455) adjusted risk of neurologic deterioration compared with those without obliteration of basal cistern. An increase of 1 point in the ICH score on admission would increase the neurologic deterioration rate by 83.2% (p = 0.010; 95% CI: 1.153 to 2.912). The ROC curves showed that the AUC for ICH score on presentation was 0.719 (p = 0.000; 95% CI: 0.613–0.826) and the cutoff value was 2.5 (sensitivity 80.5% and specificity 73.7%). Conclusion Patients had obliteration of basal cistern on initial brain CT and ICH score greater or equal to 3 at admission implies a greater danger of neurologic deterioration during hospitalization. Cautious clinical assessments and repeated brain images study are mandatory for those high-risk patients to prevent neurologic deterioration during hospitalization. |
| first_indexed | 2024-12-13T19:00:47Z |
| format | Article |
| id | doaj.art-2df9cf0ff3a24fac88eff4a530b38f39 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-13T19:00:47Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
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| series | BMC Neurology |
| spelling | doaj.art-2df9cf0ff3a24fac88eff4a530b38f392022-12-21T23:34:42ZengBMCBMC Neurology1471-23772019-05-011911910.1186/s12883-019-1312-8Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysisYu-Ni Ho0Shih-Yuan Hsu1Yu-Tsai Lin2Fu-Chang Cheng3Yu-Jun Lin4Nai-Wen Tsai5Cheng-Hsien Lu6Hung-Chen Wang7Departments of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Neurology Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Neurology Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineDepartments of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineAbstract Background Cerebellar hemorrhage is a potentially life-threatening condition and neurologic deterioration during hospitalization could lead to severe disability and poor outcome. Finds out the factors influencing neurologic deterioration during hospitalization is essential for clinical decision-making. Methods One hundred fifty-five consecutive patients who suffered a first spontaneous cerebellar hemorrhage (SCH) were evaluated in this 10-year retrospective study. This study aimed to identify potential clinical, radiological and clinical scales risk factors for neurologic deterioration during hospitalization and outcome at discharge. Results Neurologic deterioration during hospitalization developed in 17.4% (27/155) of the patient cohort. Obliteration of basal cistern (p≦0.001) and hydrocephalus (p≦0.001) on initial brain computed tomography (CT), median Glasgow Coma Scale (GCS) score at presentation (p≦0.001) and median intracerebral hemorrhage (ICH) score (P≦0.001) on admission were significant factors associated with neurologic deterioration. Stepwise logistic regression analysis showed that patients with obliteration of basal cistern on initial brain CT scan had an odds ratio (OR) of 9.17 (p = 0.002; 95% confidence interval (CI): 0.026 to 0.455) adjusted risk of neurologic deterioration compared with those without obliteration of basal cistern. An increase of 1 point in the ICH score on admission would increase the neurologic deterioration rate by 83.2% (p = 0.010; 95% CI: 1.153 to 2.912). The ROC curves showed that the AUC for ICH score on presentation was 0.719 (p = 0.000; 95% CI: 0.613–0.826) and the cutoff value was 2.5 (sensitivity 80.5% and specificity 73.7%). Conclusion Patients had obliteration of basal cistern on initial brain CT and ICH score greater or equal to 3 at admission implies a greater danger of neurologic deterioration during hospitalization. Cautious clinical assessments and repeated brain images study are mandatory for those high-risk patients to prevent neurologic deterioration during hospitalization.http://link.springer.com/article/10.1186/s12883-019-1312-8Neurologic deteriorationICH scoreSpontaneous cerebellar hemorrhageRisk factors |
| spellingShingle | Yu-Ni Ho Shih-Yuan Hsu Yu-Tsai Lin Fu-Chang Cheng Yu-Jun Lin Nai-Wen Tsai Cheng-Hsien Lu Hung-Chen Wang Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis BMC Neurology Neurologic deterioration ICH score Spontaneous cerebellar hemorrhage Risk factors |
| title | Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis |
| title_full | Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis |
| title_fullStr | Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis |
| title_full_unstemmed | Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis |
| title_short | Predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage: a retrospective analysis |
| title_sort | predictive factors of neurologic deterioration in patients with spontaneous cerebellar hemorrhage a retrospective analysis |
| topic | Neurologic deterioration ICH score Spontaneous cerebellar hemorrhage Risk factors |
| url | http://link.springer.com/article/10.1186/s12883-019-1312-8 |
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