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J Stroke Cerebrovasc Dis ; 29(11): 105242, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33066927

RESUMEN

BACKGROUND: There is geographic variability in the clinical profile and outcomes of non-traumatic intracerebral hematoma (ICH) in the young, and data for the Philippines is lacking. We aimed to describe this in a cohort from the Philippines, and identify predictors of mortality. METHODS: We performed a retrospective study of all patients aged 19-49 years with radiographic evidence of non-traumatic ICH admitted in our institution over five years. Data on demographics, risk factors, imaging, etiologies, surgical management, in-hospital mortality, and discharge functional outcomes were collected. Multivariate logistic regression analysis was done to determine factors predictive of mortality. RESULTS: A total of 185 patients were included, which had a mean age of 40.98 years and a male predilection (71.9%). The most common hematoma location was subcortical, but it was lobar for the subgroup of patients aged 19-29 years. Overall, the most common etiology was hypertension (73.0%), especially in patients aged 40-49. Conversely, the incidence of vascular lesions and thrombocytopenia was higher in patients aged 19-29. Surgery was done in 7.0% of patients. The rates of mortality and favorable functional outcome at discharge were 8.7% and 35.1%, respectively. Younger age (p = 0.004), higher NIHSS score on admission (p=0.01), higher capillary blood glucose on admission (p=0.02), and intraventricular extension of hematoma (p = 0.01) predicted mortality. CONCLUSIONS: In the Philippines, the most common etiology of ICH in young patients was hypertension, while aneurysms and AVM's were the most common etiology in the subgroup aged 19 - 29 years. Independent predictors of mortality were identified.


Asunto(s)
Hemorragia Cerebral/epidemiología , Hematoma/epidemiología , Hipertensión/epidemiología , Aneurisma Intracraneal/epidemiología , Malformaciones Arteriovenosas Intracraneales/epidemiología , Adulto , Distribución por Edad , Hemorragia Cerebral/diagnóstico por imagen , Hemorragia Cerebral/mortalidad , Hemorragia Cerebral/cirugía , Femenino , Hematoma/diagnóstico por imagen , Hematoma/mortalidad , Hematoma/cirugía , Humanos , Hipertensión/diagnóstico , Hipertensión/mortalidad , Incidencia , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/mortalidad , Aneurisma Intracraneal/cirugía , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Malformaciones Arteriovenosas Intracraneales/mortalidad , Malformaciones Arteriovenosas Intracraneales/cirugía , Masculino , Persona de Mediana Edad , Filipinas/epidemiología , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Centros de Atención Terciaria , Adulto Joven
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