CT imaging for long-term functional outcome after spontaneous intracerebral haemorrhage: A 3-year follow-up study.

PRIMARY OBJECTIVE: To define the prognostic value of head computed tomography (CT) in patients suffering from SICH after 3 years of follow-up.

RESEARCH DESIGN AND METHODS: Between January 2011 and May 2012, consecutive patients with SICH who underwent brain CT scans within the first 12 hours of presentation were prospectively included. Independent predictors of 30-day mortality and unfavourable functional outcome (modified Rankin Scale = 4-6 and Barthel Index ≤ 60) at 36 months were identified by univariable and multivariable regression analysis.

MAIN OUTCOMES AND RESULTS: A total of 228 participants were identified. According to multivariable analysis, independent CT-related predictors for 30-day mortality were intraventricular haemorrhage [IVH] (OR = 2.42; p = 0.009), haematoma volume ≥ 30 cm3 (OR = 3.32; p = 0.006), the presence of midline shift (OR = 3.77; p = 0.004) and hydrocephalus (OR = 5.22; p = 0.001). Further, IVH (OR = 3.72, 95% CI = 1.16-11.8, p = 0.026), volume of haemorrhage ≥ 30 cm3 (OR = 3.96; 95% CI = 1.65-5.84; p = 0.015) and midline shift (OR = 6.58; 95% CI = 1.33-32.4; p = 0.021) had significant associations with an mRS ≥ 4 at 36 months.

CONCLUSIONS: A favourable long-term functional outcome at 36 months and short-term survival were less likely in patients with greater volume of haematoma, presence of IVH and midline displacement.