Intracranial Pressure Monitoring-Aided Management Associated with Favorable Outcomes in Patients with Hypertension-Related Spontaneous Intracerebral Hemorrhage
- 6 March 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Translational Stroke Research
- Vol. 11 (6), 1253-1263
- https://doi.org/10.1007/s12975-020-00798-w
Abstract
To investigate the effect of intracranial pressure (ICP) monitoring on the functional outcome of patients with hypertension-related spontaneous intracerebral hemorrhage (ICH). We included 196 patients with Glasgow Coma Scale (GCS) scores of 3–12 in this observational study, of which 103 underwent ICP monitors. Binary and ordinal regression analyses were used to estimate the effect of ICP monitoring on the functional outcome. The rate of adverse events, blood pressure control, and length of hospitalization were compared between the two groups. ICP monitoring had a significant impact on the clinical outcome of patients by shifting the Extended Glasgow Outcome Scale (GOS-E) scores in a favorable direction (p = 0.027) and reducing mortality at discharge (p = 0.004) and 6 months later (p = 0.02). The rate of favorable outcome at 6 months was higher in the ICP-monitored group (p = 0.03). However, subgroup analysis showed that no relationship between ICP monitoring and clinical outcome was found for patients with GCS scores of 3–8. For patients with GCS scores of 9–12, the distribution of GOS-E scores at 6 months shifted in a favorable direction in the ICP-monitored group (p = 0.001). The rate of favorable outcome at 6 months was higher in the ICP-monitored group (p = 0.01). The mortality at discharge and 6 months later was also lower in the ICP-monitored group. Thus, our study supports the value of ICP monitoring in hypertension-related ICH patients with GCS scores of 3–12, especially those with GCS scores of 9–12.Keywords
Funding Information
- The National Natural Science Foundation of China (81000518, 81271003, 81271375, 81671200)
- The National Natural Science Foundation of China (81471241)
This publication has 30 references indexed in Scilit:
- Hematoma growth and outcomes in intracerebral hemorrhageNeurology, 2012
- Occurrence and impact of intracranial pressure elevation during treatment of severe intraventricular hemorrhage*Critical Care Medicine, 2012
- Does the Extended Glasgow Outcome Scale Add Value to the Conventional Glasgow Outcome Scale?Journal of Neurotrauma, 2012
- Guidelines for the Management of Spontaneous Intracerebral HemorrhageStroke, 2010
- IMPACT Recommendations for Improving the Design and Analysis of Clinical Trials in Moderate to Severe Traumatic Brain InjuryNeurotherapeutics, 2010
- Intracerebral haemorrhageThe Lancet, 2009
- Acute Hypertensive Response in Patients With StrokeCirculation, 2008
- Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhageNeurology, 2006
- Early mortality following spontaneous intracerebral hemorrhageNeurology, 2005
- Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhagesArquivos de Neuro-Psiquiatria, 2003