Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage
Background: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation. Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome. Methods: In this multicenter regi...
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| Format: | Article |
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Permanyer
2022-01-01
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| Series: | Revista de Investigación Clínica |
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| Online Access: | https://www.clinicalandtranslationalinvestigation.com/frame_esp.php?id=411 |
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| author | José L. Ruiz-Sandoval Javier Aceves-Montoya Erwin Chiquete Germán López-Valencia Alejandro Lara-López Manuel Sánchez-González Amado Jiménez-Ruiz Fernando Barinagarrementería Luis Murillo-Bonilla Antonio Arauz-Góngora Fernando Daniel Flores-Silva Carlos Cantú-Brito |
| author_facet | José L. Ruiz-Sandoval Javier Aceves-Montoya Erwin Chiquete Germán López-Valencia Alejandro Lara-López Manuel Sánchez-González Amado Jiménez-Ruiz Fernando Barinagarrementería Luis Murillo-Bonilla Antonio Arauz-Góngora Fernando Daniel Flores-Silva Carlos Cantú-Brito |
| author_sort | José L. Ruiz-Sandoval |
| collection | DOAJ |
| description | Background: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation. Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome. Methods: In this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied. Clinical data, arrival conditions, and prognostic scores were analyzed. Multivariate models were built to find independent predictors of < 6 h arrival (logistic regression) and in-hospital death (Cox proportional-hazards model). Results: Among the 473 patients analyzed (51% women, median age 63 years), the median delay since onset to admission was 6.25 h (interquartile range: 2.5-24 h); 7.8% arrived in < 1 h, 26.3% in < 3 h, 45.3% in < 6 h, and 62.3% in < 12 h. The in-hospital, 30-day and 90-day case fatality rates were 28.8%, 30.0%, and 32.6%, respectively. Predictors of arrival in < 6 h were hypertension treatment (odds ratios [OR]: 1.675, 95% confidence intervals [CI]: 1.030-2.724), >- 3 years of schooling (OR: 1.804, 95% CI: 1.055-3.084), and seizures at ICH onset (OR: 2.416, 95% CI: 1.068-5.465). Predictors of death (56.9% neurological) were systolic blood pressure > 180 mmHg (hazards ratios [HR]: 1.839, 95% CI: 1.031-3.281), ICH score >- 3 (HR: 2.302, 95% CI: 1.300-4.074), and admission Glasgow Coma Scale < 8 (HR: 4.497, 95% CI: 2.466-8.199). Early arrival was not associated with outcome at discharge, 30 or 90 days. Conclusions: In this study, less than half of patients with ICH arrived to the hospital in < 6 h. However, early arrival was not associated with the short-term outcome in this data set. |
| first_indexed | 2024-12-13T01:22:33Z |
| format | Article |
| id | doaj.art-922a6d3c3f39497eb7badd911b478929 |
| institution | Directory Open Access Journal |
| issn | 0034-8376 2564-8896 |
| language | English |
| last_indexed | 2024-12-13T01:22:33Z |
| publishDate | 2022-01-01 |
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| record_format | Article |
| series | Revista de Investigación Clínica |
| spelling | doaj.art-922a6d3c3f39497eb7badd911b4789292022-12-22T00:04:12ZengPermanyerRevista de Investigación Clínica0034-83762564-88962022-01-0174110.24875/RIC.21000471Hospital Arrival and Functional Outcome after Intracerebral HemorrhageJosé L. Ruiz-Sandoval0Javier Aceves-Montoya1Erwin Chiquete2Germán López-Valencia3Alejandro Lara-López4Manuel Sánchez-González5Amado Jiménez-Ruiz6Fernando Barinagarrementería7Luis Murillo-Bonilla8Antonio Arauz-Góngora9Fernando Daniel Flores-Silva10Carlos Cantú-Brito11Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal.; Department of Neurosciences, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jal., MexicoDepartment of Medicine, Universidad Autónoma de Sinaloa, Sin., MexicoDepartment of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Neurosciences, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jal., MexicoDepartment of Physiology, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara, Guadalajara, Jal., MexicoDepartment of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal., MexicoDepartment of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal., MexicoDepartment of Neurology, Hospital H+, Querétaro, Qro., MexicoDepartment of Neurology, Facultad de Medicina, Universidad Autónoma de Guadalajara, Guadalajara, Jal., MexicoStroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, MexicoDepartment of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoDepartment of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoBackground: Intracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation. Objective: This study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome. Methods: In this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied. Clinical data, arrival conditions, and prognostic scores were analyzed. Multivariate models were built to find independent predictors of < 6 h arrival (logistic regression) and in-hospital death (Cox proportional-hazards model). Results: Among the 473 patients analyzed (51% women, median age 63 years), the median delay since onset to admission was 6.25 h (interquartile range: 2.5-24 h); 7.8% arrived in < 1 h, 26.3% in < 3 h, 45.3% in < 6 h, and 62.3% in < 12 h. The in-hospital, 30-day and 90-day case fatality rates were 28.8%, 30.0%, and 32.6%, respectively. Predictors of arrival in < 6 h were hypertension treatment (odds ratios [OR]: 1.675, 95% confidence intervals [CI]: 1.030-2.724), >- 3 years of schooling (OR: 1.804, 95% CI: 1.055-3.084), and seizures at ICH onset (OR: 2.416, 95% CI: 1.068-5.465). Predictors of death (56.9% neurological) were systolic blood pressure > 180 mmHg (hazards ratios [HR]: 1.839, 95% CI: 1.031-3.281), ICH score >- 3 (HR: 2.302, 95% CI: 1.300-4.074), and admission Glasgow Coma Scale < 8 (HR: 4.497, 95% CI: 2.466-8.199). Early arrival was not associated with outcome at discharge, 30 or 90 days. Conclusions: In this study, less than half of patients with ICH arrived to the hospital in < 6 h. However, early arrival was not associated with the short-term outcome in this data set.https://www.clinicalandtranslationalinvestigation.com/frame_esp.php?id=411Arrival. Cerebrovascular. Death. Intracerebral hemorrhage. Outcome. Stroke. |
| spellingShingle | José L. Ruiz-Sandoval Javier Aceves-Montoya Erwin Chiquete Germán López-Valencia Alejandro Lara-López Manuel Sánchez-González Amado Jiménez-Ruiz Fernando Barinagarrementería Luis Murillo-Bonilla Antonio Arauz-Góngora Fernando Daniel Flores-Silva Carlos Cantú-Brito Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage Revista de Investigación Clínica Arrival. Cerebrovascular. Death. Intracerebral hemorrhage. Outcome. Stroke. |
| title | Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage |
| title_full | Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage |
| title_fullStr | Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage |
| title_full_unstemmed | Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage |
| title_short | Hospital Arrival and Functional Outcome after Intracerebral Hemorrhage |
| title_sort | hospital arrival and functional outcome after intracerebral hemorrhage |
| topic | Arrival. Cerebrovascular. Death. Intracerebral hemorrhage. Outcome. Stroke. |
| url | https://www.clinicalandtranslationalinvestigation.com/frame_esp.php?id=411 |
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