Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2005 Nov;76(11):1534–1538. doi: 10.1136/jnnp.2004.055145

Long term survival after primary intracerebral haemorrhage: a retrospective population based study

R Fogelholm 1, K Murros 1, A Rissanen 1, S Avikainen 1
PMCID: PMC1739413  PMID: 16227546

Abstract

Objectives: To determine the long term survival and predictors of death in patients with primary intracerebral haemorrhage (ICH) in Central Finland.

Methods: Data were collected retrospectively on all adult patients with first ever ICH in Central Finland county between September 1985 and December 1991. The survival of all patients at the end of December 2002 was investigated. Kaplan–Meier survival curves were constructed and factors associated with both early (⩽28 days) and late deaths determined. Long term survival was compared with the general Finnish population of the same age and sex distribution. The causes of death were compared with those of the population of Central Finland.

Results: 411 patients with first ever ICH were identified, 199 men (mean age 64.9 years) and 212 women (mean age 69.5); 30 died before hospital admission, and 208 (50.6%) within the first 28 days. In Kaplan–Meier analysis, at 16 years the cumulative survival was 3.2% for men and 9.8% for women. The 28 day survivors had a 4.5-fold increased annual risk of dying during the first year after ICH, and 2.2-fold during years 2 to 6. On admission, significant independent predictors of death within the first four weeks were unconsciousness, lateral shift of cerebral midline structures, mean arterial pressure ⩾134 mm Hg, hyperglycaemia, anticoagulant treatment, and ventricular extrasystoles. Predictors of late death for the 28 day survivors were old age, male sex, and heart failure.

Conclusions: Primary intracerebral haemorrhage has a poor short and long term outcome. The results emphasise the importance of primary and secondary prevention for ICH.

Full Text

The Full Text of this article is available as a PDF (71.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson C. S., Chakera T. M., Stewart-Wynne E. G., Jamrozik K. D. Spectrum of primary intracerebral haemorrhage in Perth, Western Australia, 1989-90: incidence and outcome. J Neurol Neurosurg Psychiatry. 1994 Aug;57(8):936–940. doi: 10.1136/jnnp.57.8.936. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bamford J., Sandercock P., Dennis M., Burn J., Warlow C. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project--1981-86. 2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 1990 Jan;53(1):16–22. doi: 10.1136/jnnp.53.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brønnum-Hansen H., Davidsen M., Thorvaldsen P., Danish MONICA Study Group Long-term survival and causes of death after stroke. Stroke. 2001 Sep;32(9):2131–2136. doi: 10.1161/hs0901.094253. [DOI] [PubMed] [Google Scholar]
  4. Cheung Raymond Tak Fai, Zou Liang-Yu. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke. 2003 Jun 12;34(7):1717–1722. doi: 10.1161/01.STR.0000078657.22835.B9. [DOI] [PubMed] [Google Scholar]
  5. Daverat P., Castel J. P., Dartigues J. F., Orgogozo J. M. Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis. Stroke. 1991 Jan;22(1):1–6. doi: 10.1161/01.str.22.1.1. [DOI] [PubMed] [Google Scholar]
  6. Dennis M. S., Burn J. P., Sandercock P. A., Bamford J. M., Wade D. T., Warlow C. P. Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project. Stroke. 1993 Jun;24(6):796–800. doi: 10.1161/01.str.24.6.796. [DOI] [PubMed] [Google Scholar]
  7. Fieschi C., Carolei A., Fiorelli M., Argentino C., Bozzao L., Fazio C., Salvetti M., Bastianello S. Changing prognosis of primary intracerebral hemorrhage: results of a clinical and computed tomographic follow-up study of 104 patients. Stroke. 1988 Feb;19(2):192–195. doi: 10.1161/01.str.19.2.192. [DOI] [PubMed] [Google Scholar]
  8. Fogelholm R., Nuutila M., Vuorela A. L. Primary intracerebral haemorrhage in the Jyväskylä region, central Finland, 1985-89: incidence, case fatality rate, and functional outcome. J Neurol Neurosurg Psychiatry. 1992 Jul;55(7):546–552. doi: 10.1136/jnnp.55.7.546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Franke C. L., van Swieten J. C., Algra A., van Gijn J. Prognostic factors in patients with intracerebral haematoma. J Neurol Neurosurg Psychiatry. 1992 Aug;55(8):653–657. doi: 10.1136/jnnp.55.8.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Giroud M., Gras P., Chadan N., Beuriat P., Milan C., Arveux P., Dumas R. Cerebral haemorrhage in a French prospective population study. J Neurol Neurosurg Psychiatry. 1991 Jul;54(7):595–598. doi: 10.1136/jnnp.54.7.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hallström Björn, Norrving Bo, Lindgren Arne. Stroke in Lund-Orup, Sweden: improved long-term survival among elderly stroke patients. Stroke. 2002 Jun;33(6):1624–1629. doi: 10.1161/01.str.0000017222.48968.6e. [DOI] [PubMed] [Google Scholar]
  12. Hankey G. J., Jamrozik K., Broadhurst R. J., Forbes S., Burvill P. W., Anderson C. S., Stewart-Wynne E. G. Five-year survival after first-ever stroke and related prognostic factors in the Perth Community Stroke Study. Stroke. 2000 Sep;31(9):2080–2086. doi: 10.1161/01.str.31.9.2080. [DOI] [PubMed] [Google Scholar]
  13. Hardie Kate, Hankey Graeme J., Jamrozik Konrad, Broadhurst Robyn J., Anderson Craig. Ten-year survival after first-ever stroke in the perth community stroke study. Stroke. 2003 Jul 3;34(8):1842–1846. doi: 10.1161/01.STR.0000082382.42061.EE. [DOI] [PubMed] [Google Scholar]
  14. Hemphill J. C., 3rd, Bonovich D. C., Besmertis L., Manley G. T., Johnston S. C. The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke. 2001 Apr;32(4):891–897. doi: 10.1161/01.str.32.4.891. [DOI] [PubMed] [Google Scholar]
  15. Hill M. D., Silver F. L., Austin P. C., Tu J. V. Rate of stroke recurrence in patients with primary intracerebral hemorrhage. Stroke. 2000 Jan;31(1):123–127. doi: 10.1161/01.str.31.1.123. [DOI] [PubMed] [Google Scholar]
  16. Masè G., Zorzon M., Biasutti E., Tasca G., Vitrani B., Cazzato G. Immediate prognosis of primary intracerebral hemorrhage using an easy model for the prediction of survival. Acta Neurol Scand. 1995 Apr;91(4):306–309. doi: 10.1111/j.1600-0404.1995.tb07011.x. [DOI] [PubMed] [Google Scholar]
  17. Moulin T., Tatu L., Crépin-Leblond T., Chavot D., Bergès S., Rumbach T. The Besançon Stroke Registry: an acute stroke registry of 2,500 consecutive patients. Eur Neurol. 1997;38(1):10–20. doi: 10.1159/000112896. [DOI] [PubMed] [Google Scholar]
  18. Portenoy R. K., Lipton R. B., Berger A. R., Lesser M. L., Lantos G. Intracerebral haemorrhage: a model for the prediction of outcome. J Neurol Neurosurg Psychiatry. 1987 Aug;50(8):976–979. doi: 10.1136/jnnp.50.8.976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Tuhrim S., Dambrosia J. M., Price T. R., Mohr J. P., Wolf P. A., Heyman A., Kase C. S. Prediction of intracerebral hemorrhage survival. Ann Neurol. 1988 Aug;24(2):258–263. doi: 10.1002/ana.410240213. [DOI] [PubMed] [Google Scholar]
  20. Vermeer S. E., Algra A., Franke C. L., Koudstaal P. J., Rinkel G. J. E. Long-term prognosis after recovery from primary intracerebral hemorrhage. Neurology. 2002 Jul 23;59(2):205–209. doi: 10.1212/wnl.59.2.205. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES