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Prediction of short-term prognosis in elderly patients with spontaneous intracerebral hemorrhage

2021Journal article Restricted
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dc.contributor.authorBatista, António
dc.contributor.authorOsório, Rui
dc.contributor.authorVarela, Ana
dc.contributor.authorGuilherme, Patrícia
dc.contributor.authorMarreiros, Ana
dc.contributor.authorPais, Sandra
dc.contributor.authorNzwalo, Hipólito
dc.date.accessioned2021-07-19T11:54:26Z
dc.date.available2021-07-19T11:54:26Z
dc.date.issued2021
dc.description.abstractAim The incidence of spontaneous intracerebral hemorrhage (SICH) increases with age. Data on SICH mortality in the very old are sparse. We aimed to describe the predictors of 30-day SICH mortality in the very elderly in southern Portugal. Methods A total of 256 community representative SICH patients aged >= 75 years (2009-2016) were included. Multiple logistic regression was used to identify predictors of 30-day mortality. Results Mean age was 82.1 years; 57.4% males. The 30-day case fatality was 38.7%. The frequency of patients taking anticoagulants (29.3% vs. 11.5%); comatose (46.9% vs. 2.5%); with hematoma volume >= 30 mL (64.6% vs. 13.4%); intraventricular dissection (78.8% vs. 27.4%) was higher in deceased patients (p < 0.05). Survivors were more often admitted to stroke unit (SU) (68.2 vs. 31.3%) and had lower mean admission glycaemia values (p < 0.05). The likelihood of death was increased in patients with higher admission hematoma volume (>= 30 mL) (OR: 8.817, CI 1.753-44.340, p = 0.008) and with prior to SICH history of >= 2 hospitalizations OR = 1.022, CI 1.009-1.069, p = 0.031). Having higher Glasgow coma scale score, OR: 0.522, CI 0.394-0.692, p < 0.001, per unit was associated with reduced risk of death. Age was not an independent risk factor of short-term death. Conclusions The short-term mortality is high in very elderly SICH. Prior to SICH history of hospitalization, an indirect and gross marker of coexistent functional reserve, not age per se, increases the risk of short-term death. Other predictors of short-term death are potentially manageable reinforcing the message against any defeatist attitude toward elderly patients with SICH. Key summary pointsAim Identification of predictors of short-term death after spontaneous intracerebral hemorrhage (SICH) in the elderly. Findings The short-term case fatality (38.7%) after SICH is high in the elderly. Hematoma volume, decreased level of consciousness and functional reserve, but not age per se, increase the risk of short-term death. Message Age per se should not justify any decision of withholding best treatment in elderly SICH patients. Offering the best acute treatment can potentially improve the clinical outcome.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBatista, A., Osório, R., Varela, A. et al. Prediction of short-term prognosis in elderly patients with spontaneous intracerebral hemorrhage. Eur Geriatr Med (2021). https://doi.org/10.1007/s41999-021-00529-wpt_PT
dc.identifier.doi10.1007/s41999-021-00529-wpt_PT
dc.identifier.issn1878-7649
dc.identifier.urihttp://hdl.handle.net/10400.1/16783
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectIntracerebral hemorrhagept_PT
dc.subjectMortalitypt_PT
dc.subjectOldestpt_PT
dc.subjectOldpt_PT
dc.subjectPrognosispt_PT
dc.titlePrediction of short-term prognosis in elderly patients with spontaneous intracerebral hemorrhagept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleEuropean Geriatric Medicinept_PT
person.familyNameMarreiros
person.familyNamePais
person.familyNameNzwalo
person.givenNameAna
person.givenNameSandra
person.givenNameHipólito
person.identifier337064
person.identifier.ciencia-id9A12-9450-7051
person.identifier.ciencia-id1F1A-ED3C-3260
person.identifier.ciencia-id2C1F-E4F3-2C79
person.identifier.orcid0000-0001-9410-4772
person.identifier.orcid0000-0001-8472-4994
person.identifier.orcid0000-0002-1502-3534
person.identifier.ridAAG-3931-2020
person.identifier.scopus-author-id57194785077
person.identifier.scopus-author-id56469150800
person.identifier.scopus-author-id36057285600
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
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relation.isAuthorOfPublication287f7d4e-5ad8-4794-b526-c61d32c00446
relation.isAuthorOfPublication.latestForDiscovery287f7d4e-5ad8-4794-b526-c61d32c00446

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