Predictors of 30-day Mortality and 90-day Functional Recovery after Primary Pontine Hemorrhage

다국어 초록 (Multilingual Abstract)

The factors related to death and functional recovery after primary pontine hemorrhage (PPH) in Koreans has not been well defined. The authors sought to identify independent predictors of death and functional recovery after PPH using data obtained at a single institute. Data were collected retrospectively on 281 patients with PPH admitted to the Stroke Unit at our hospital between January 1, 2000 and December 31, 2009. Multivariate logistic regression analysis was used to evaluate the associations between selected variables and 30-day mortality and 90-day functional recovery after PPH. One-hundred and ten patients (39.1%) died within 30 days of PPH and 27 patients (9.6%) achieved functional recovery within 90 days. By multivariate analysis, unconsciousness, dilated pupils,abnormal respiration, systolic blood pressure < 100 mmHg, hydrocephalus, and conservative treatment were found to be predictors of 30-day mortality, whereas consciousness, intact motor function, no history of hypertension or diabetes mellitus,intact eye movement, a hematoma volume of < 5 mL, no ventricular hemorrhage, and normally sized ventricle were found to be predictors of 90-day functional recovery. The present findings suggest that systolic hypotension of less than 100 mmHg may predict 30-day mortality and a history of underlying hypertension and diabetes mellitus may predict 90-day functional recovery.

참고문헌 (Reference)

1 Broderick JP, "Volume of intracerebral hemorrhage. A powerful and easy to use predictor of 30 day mortality" 24 : 987-993, 1993

2 Han YP, "Treatment of pontine hemorrhage" 14 : 695-704, 1985

3 Dziewas R, "The prognostic impact of clinical and CT parameters in patients with pontine hemorrhage" 16 : 224-229, 2003

4 Kushner MJ, "The clinical manifestations of pontine hemorrhage" 35 : 637-643, 1985

5 Dae Sung Jung, "The Predictors of Survival and Functional Outcomein Patients with Pontine Hemorrhage" 대한신경외과학회 41 (41): 82-87, 2007

6 Hong JT, "Surgical outcome of hypertensive pontine hemorrhages: experience of 13 cases" 27 : 59-65, 1998

7 Fewel ME, "Spontaneous intracerebral hemorrhage: a review" 15 : 1-, 2003

8 Murata Y, "Relationship between the clinical manifestations, computed tomographic findings and the outcome in 80 patients with primary pontine hemorrhage" 167 : 107-111, 1999

9 Hyun-Seok Park, "Recent Epidemiological Trends of Stroke" 대한신경외과학회 43 (43): 16-20, 2008

10 Chung CS, "Primary pontine hemorrhage: a new CT classification" 42 : 830-834, 1992

11 Masiyama S, "Pontine haemorrhage: a clinical analysis of 26 cases" 48 : 658-662, 1985

12 Korean Neurological Association, "Korean Neurological Association Epidemiology of cerebrovascular disease in Korea: a collaborative study, 1989-1990" 8 : 281-289, 1993

13 Ikehara S, "Japan Collaborative Cohort Study Group. Alcohol consumption and mortality from stroke and coronary heart disease among Japanese men and women: the Japan collaborative cohort study" 39 : 2936-2942, 2008

14 van Swieten JC, "Interobserver agreement for the assessment of handicap in stroke patients" 19 : 604-607, 1988

15 Jeong JH, "Hypertensive pontine microhemorrhage" 33 : 925-929, 2002

16 Broderick JP, "Guidelines for the management of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association" 30 : 905-915, 1999

17 Hara T, "Functional outcome of primary pontine hemorrhage: conservative treatment or stereotaxic surgery" 29 : 823-829, 2001

18 Manno EM, "Emerging medical and surgical management strategies in the evaluation and treatment of intracerebral hemorrhage" 80 : 420-433, 2005

19 Wijdicks EF, "Clinical profiles predictive of outcome in pontine hemorrhage" 49 : 1342-1346, 1997

20 Balci K, "Clinical and neuroradiological predictors of mortality in patients with primary pontine hemorrhage" 108 : 36-39, 2005

21 Rabinstein AA, "Cause is the main predictor of outcome in patients with pontine hemorrhage" 17 : 66-71, 2004

22 Wessels T, "CT findings and clinical features as markers for patient outcome in primary pontine hemorrhage" 25 : 257-260, 2004