Spontaneous intracerebral haemorrhage: an observational study on its risk factors, assessment of intracerebral haemorrhage score and its relation to outcome in a tertiary care hospital

Background and aims: ICH, a subtype of stroke, is a devastating condition and is usually caused by the rupture of small penetrating arteries secondary to hypertensive changes or other vascular abnormalities. This paper aims to evaluate the risk factors associated with spontaneous ICH and assessment of ICH score as a prognostic score for determining short-term outcomes. Methods: This institution-based observational study was conducted on 140 patients attending the emergency and outpatient departments of Medicine and Neurology at Gauhati Medical College and Hospital. All patients had undergone NCCT brain, Complete hemogram, Coagulation profile, Renal function test, Fasting lipid profile, Thyroid profile, Glycosylated Haemoglobin, FBS, and PPBS. ECG and MRI brain, including MRA and MRV, were also done, if necessary. Results: The study showed that 72.85% of the patients had hypertension,13.57% had diabetes mellitus,10% had chronic kidney disease, and 5% patients had a history of usage of anticoagulants/antiplatelets. The ICH score calculated showed that patients with an ICH score of 0-1 had a favourable outcome, as reflected by their low mortality percentage. In contrast, 80 % of patients with an ICH score of 4 and 100 % of patients with an ICH score of 5 died, which showed that the percentage of mortality increased with increasing ICH score. There was no patient with an ICH score of 6. Conclusion: Systemic hypertension was the most common risk factor among patients with spontaneous intracerebral haemorrhage, followed by diabetes mellitus, chronic kidney disease and use of anticoagulants or antiplatelets, and ICH score seemed to predict patients with spontaneous intracerebral bleeding effectively. A low ICH score was compatible with a good outcome, whereas a high one predicted more mortality.

Keywords: Systemic hypertension; diabetes mellitus; chronic kidney disease; anti-coagulants; antiplatelets