Prediction of factors influencing hemorrhagic stroke death with brain herniation in teaching hospitals

Abstract

Objectives: The purpose of this study was to identify and analyze the predictors of mortality in the cases of hemorrhagic stroke with brain herniation of hospitalized patients. Methods: In this retrospective cohort study, we analyzed 1,330 cases of hemorrhagic stroke with brain herniation from January 2015 to October 2020, and used logistic regression to identify the cause of death of hemorrhagic stroke with brain herniation. Results: A total of 1,330 stroke patients with brain herniation were identified. The mean age was 63.40±61.00 years and 56.50% of them were male. A total of 78.80% of the observed patients were discharged directly after recovery, 2.00% were discharged at the personal/family request, and number of patients who died after being treated 19.20% died (30.90% died after being treated for <48 hours, and 69.10% died after being treated for ≥48 hours). Patients who were ≥65 years old had more tendency to die than those who were younger, with a 95% confidence interval (CI) 6,859-26,486; p=0.001). The higher the systolic and diastolic blood pressure was, the greater the probability of dying after hospitalization (odds ratio [OR] 2.340, CI 1.334-4.104, p=0.022, OR 2.110, CI 1.042-4.273, p=0.026), the lower Glasgow coma scale (GCS) score at admission (<5), the more tendency for a patient to die (OR 1.376, CI 0.816–2.320, p=0.038) would be. Conclusions: Patient’s age ≥65 years, high systolic blood pressure, high diastolic blood pressure, and GCS score <5 are predictors associated with the mortality of hemorrhagic stroke with brain herniation. The implications of these findings, if confirmed in prospective studies, would raise important policy considerations both in hospitals and at the overall health level, particularly regarding post-acute care.