Journal of Korean Society of Geriatric Neurosurgery 2013;9(2):91-96.
Published online December 30, 2013.
The Prognostic Factors of Patients with Intracerebral Hemorrhage Undergoing Maintenance Hemodialysis
Sang-Yoon Lee , Jae-Hyone Shim , Seung-Jin Rho , Hak-Ki Choi , Hwa-Seung Park , Chang-Gu Ghang
Department of Neurosurgery, Bongseng Memorial Hospital, Busan, Korea
Abstract
Objective
The purpose of this study was to evaluate the prognostic factors of intracerebral hemorrhage (ICH) in patients undergoing maintenance hemodialysis (HD).
Methods
We retrospectively analyzed data from 23 patients with ICH who underwent maintenance HD from July 2007 to April 2012. We categorized these patients into 2 groups according to their Glasgow outcome scale (GOS) score obtained at their last follow-up. Patients with GOS scores ≥4 were considered to have favorable outcomes, whereas patients with GOS scores ≤3 were considered to have unfavorable outcomes. Radiological, demographical, and clinical features were analyzed, and included age, sex, diabetes mellitus diagnosis, history of dialysis, serum albumin, initial Glasgow coma scale (GCS), initial blood pressure (systolic, diastolic), history of stereotactic aspiration or craniectomy, hematoma (volume, location, shape), and hematoma enlargement.
Results
Fifteen patients achieved favorable outcomes (65.2%), but 8 patients showed unfavorable outcomes (34.8%). Five patients expired (mortality, 21.7%). In this study, the significant prognostic factors were initial GCS score (p=0.002), brainstem involvement (0.032), initial systolic blood pressure (p=0.001), and hematoma enlargement (p=0.008). The prognosis showed no statistically significant correlation with an operative procedure, despite that stereotactic aspiration of hematoma often led to a favorable outcome (p=0.073).
Conclusion
Even if the initial condition cannot be changed, the prognosis for these patients can be improved by carefully considering dynamic factors such as initial systolic blood pressure and hematoma enlargement.
Key Words: HemodialysisㆍIntracerebral hemorrhageㆍPrognosis


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