From the Department of Neurosurgery, Brain Research Institute, Niigata
University, Niigata, Japan.
Correspondence to Yukihiko Fujii, MD, PhD, Department of Neurosurgery, Brain Research Institute, Niigata University, Asahimachi 1, Niigata 951, Japan. E-mail yfujii{at}bri.niigata-u.ac.jp
Background and Purpose—We conducted
this study to determine, through use of multivariate
analyses, the independent predictors of hematoma enlargement
occurring after hospital admission in patients with spontaneous
intracerebral hemorrhage (ICH).
Methods—We reviewed 627 patients with ICH admitted within 24
hours of onset. The first CT was performed at admission and the second
within 24 hours of admission, and a blood sample was taken for
laboratory examinations. Univariate and
multivariate analyses were performed to assess
the relationships between hematoma enlargement and time from onset,
consciousness level, CT findings, amount of alcohol consumption,
systolic blood pressure at and after admission, clinical
outcome, and hematologic parameters.
Results—Eighty-eight patients (14.0%) showed enlarged hematomas
after admission. Multivariate analyses revealed
that the following five factors were independently associated with
hematoma enlargement: the time from onset (odds ratio [OR], 0.26 for
a 1-SD change; 4.9 hours; P<0.001); the amount of
alcohol consumption (OR, 1.50 for 1 SD; 46.3 g/d;
P=0.002); the sharp of hematoma (OR, 1.40 for 1 SD; 0.45
round; P=0.006); the presence of consciousness
disturbance (OR, 1.38 for 1 SD; 0.50 coma;
P=0.026); and the level of fibrinogen (OR, 0.74 for 1
SD; 87.1 mg/dL; P=0.042). Hematoma enlargement was an
independent factor increasing the mortality rate in the ICH patients
(OR, 1.57; P<0.001).
Conclusions—A particularly high likelihood of hematoma
enlargement was observed in patients who (in order of importance) were
admitted shortly after onset, who were heavy drinkers; who had an
irregularly shaped hematoma, whose consciousness was disturbed, and who
had a low level of fibrinogen.
© 1998 American Heart Association, Inc.
Original Contributions
Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage
Key Words: alcohol drinking • blood coagulation disorders • tomography, x-ray computed • intracerebral hemorrhage • risk factors
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