1Consultant Physician, Health Department, Govt. of Bihar
2Assistant Professor, Department of Pharmacology, IGIMS, Patna
3Associate Professor, Department of Biochemistry, IGIMS, Patna
4Assistant Professor, Department of Medicine, Darbanga Medical College, Laheriasarai
5Associate Professor, Department of Pharmacology, IGIMS, Patna
6Professor, Department of Pathology, IGIMS, Patna. Email: jiutram@rediffmail.com
*Corresponding Author: Dr. J.R. Keshari, Associate Professor, Department of Biochemistry, IGIMS, Patna. Mobile: 8986170490. Email: jrkeshari@gmail.com
Online published on 18 January, 2018.
Intracerebral haemorrhage (ICH), third most frequent cause of stroke with high rate of mortality, morbidity and permanent disability in spite of adequate management. In numerous studies, multivariate analysis using the technique of logistic regression identified three variables which were most predictive of prognosis i.e. Glasgow COMA Scale score, Haemorrhage size and Intraventricular extension of blood.
The present study was attempted to asses and correlate the volume, site of primary intraparenchymal haemorrhage and Glasgow coma scale score, midline shift, intra ventricular extension, hydrocephalus, ECG changes, vomiting, aspiration and gastric haemorrhage at the time of presentation with the clinical picture. The prognosis in each case was evaluated in terms of mortality and morbidity (i.e., resultant disability as assessed by Barthel Activities of Daily Living Score). CT was used for radiological diagnosis. Statistical analysis was performed to correlate the patient outcome and each prognostic factor using the χ2test (Chisquare test).
The statistical data analysis to correlate patient's outcome with location of intracerebral haemorrhage using χ2 square test had shown no correlation (χ2 2.26, P > 0.10) but volume of intracerebral haemorrhage, ICH/IVE, midline shift, Glasgow coma scale score, vomiting, aspiration, hydrocephalus, Gastric haemorrhage and ECG changes had shown significant correlation (χ2 = 35.44, P<0.001), (χ2 =12.53, P <0.001), (χ2 = 18.89, P < 0.001), (χ2 = 31.84, P < 0.001), (χ2 = 9.08, P < 0.005), (χ2 = 9.08, P < 0.005), (χ2=15.10, P < 0.001), (χ2 = 15.10, P < 0.005) and (χ2 = 20.96, P < 0.001) respectively in this study.
Multivariate analysis using χ2 (Chi-square) test out of these variables studied, shift, GCS and volume of haemorrhage had significant effect on mortality. Vomiting, Aspiration, Gastric haemorrhage and Hydrocephalous and ECG changes had also significant effect on prognosis. Hence these variants come to use as significant prognostic parameters in follow up of cases of I.C.H.
Intracerebral haemorrhage, Barthel Activities of Daily Living Score, Glasgow COMA Scale score, Haemorrhage size, Intraventricular extension of blood
