PREDICTORS OF EARLY DETERIORATION AND MORTALITY IN BLACK-AMERICANS WITH SPONTANEOUS INTRACEREBRAL HEMORRHAGE

Background and Purpose Black Americans with spontaneous intracerebral hemorrhage (SIGH) may have unique clinical characteristics that affect outcome. The aim of this study was to determine the prognostic value of clinical characteristics and initial CT scan for outcome in black Americans with SIGH. Methods Clinical and demographic data were extracted from the charts of 182 consecutive black Americans admitted for SIGH diagnosed by clinical criteria and initial CT scan. Hemorrhage volumes were calculated from admission CT scans by a computerized method. Univariate and multiple logistic regression analyses were performed to determine independent predictors of early deterioration (defined as a decrease from an initial Glasgow Coma Scale score >12 by greater than or equal to 4 points within 24 hours from presentation) and mortality. Results Both hemorrhage volume and ventricular extension were significant, independent predictors of early deterioration (odds ratio [OR], 6.78; 95% confidence interval [CI], 1.89 to 24.35 and OR, 4.67; 95% CI, 1.30 to 16.72, respectively) and mortality (OR, 6.66; 95% CI, 2.85 to 15.58 and OR, 4.23; 95% CI, 1.82 to 9.82, respectively). A Glasgow Coma Scale score less than or equal to 12 also predicted mortality (OR, 3.23; 95% CI, 1.46 to 7.14). Initial mean arterial pressure was not an independent predictor of early deterioration or mortality. Conclusions Hemorrhage volume and ventricular extension are the best predictors of early deterioration and mortality in black Americans with SICH.