Predicting In-hospital Mortality in Bulgarian Patients with Spontaneous Intracerebral Hemorrhage

Abstract

Intracerebral hemorrhage (ICH) is a life-threatening condition associated with high mortality and morbidity. This study aimed to identify the predictors of in-hospital mortality in patients with spontaneous ICH based on initial evaluation. We conducted a retrospective study of patients admitted with ICH between January 2019 and January 2024, collecting demographic, clinical, laboratory, and computed tomographic data. A total of 98 patients were included, with 31 (31.6%) deaths occurring during the hospital stay. Univariate regression analysis identified several potential independent predictors of in-hospital mortality, including lower Glasgow Coma Scale score (GCS), higher National Institutes of Health Stroke Scale (NIHSS) and ICH scores, elevated white blood cell (WBC) count and blood glucose levels, higher hematoma volume, the presence of midline shift, subarachnoid and intraventricular expansions, island sign, satellite sign and irregular shape. However, multivariate regression analysis revealed that only NIHSS score (OR = 1.24, 95% CI = 1.12–1.42, p ≤ 0.001) and GCS score (OR = 0.15, 95% CI = 0.02–0.67, p = 0.02) were independent predictors of in-hospital mortality. In conclusion, our results suggest that lower GCS and higher NIHSS on admission are significant predictors for in-hospital mortality in ICH patients, highlighting their importance for clinical early decision-making.