POSSIBILITIES OF SHORT-TERM SPONTANEOUS SUPRATENTORIAL INTRACEREBRAL HAEMORRHAGE VITAL PROGNOSIS VERIFICATION DURING CONSERVATIVE THERAPY ON THE GROUND OF COMPLEX CLINICAL, NEUROVISUALIZATION INVESTIGATION AND ELECTROENCEPHALOGRAPHY DATA
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11377Keywords:
intracerebral hemorrhage, computed tomography, electroencephalography, vital prognosisAbstract
The aim – to elaborate the integrated prognostic criteria for spontaneous supratentorial intracerebral hemorrhage (SSIСH) lethal outcome that are based on the data of complex clinical, neurovisualization and electroencephalographic investigations on the ground of conservative therapy.
Material and Methods. Prospective, cohort and comparative study was conducted in 156 patients in SSICH acute period on the ground of conservative therapy, who were admitted during 24 hours from the disease onset. Clinical and neurological investigation included evaluation according to Full Outline of UnResponsiveness and National Institute of Health Stroke Scale. Cerebral structures detection was made by using computed tomography. Electroencephalography was performed in the first 48 hours. Thus, values of absolute spectral rhythm power of delta, theta, alpha, beta bands were evaluated separately for affected and intact hemispheres. Than integrated coefficients that reflect different balance of mentioned indexes were calculated. Logistic regression and ROC-analysis were used for elaboration of prognostic criteria.
Results. Lethal outcome during acute period of SSICH was detected in 42 (26.9 %) cases. It was revealed that summary score according to coma Full Outline of UnResponsiveness scale (OR (95 % CІ) = 0.29 (0.13–0.69), р=0.0050), intracerebral hemorrhage volume (OR (95 % CI) = 1.05 (1.01–1.10), р=0.0270), value of DTABR in affected hemisphere (OR (95 % CI) = 1.70 (1.14–1.53), р=0.0092) and DTR coefficient in intact hemisphere (OR (95 % CI) = 1.60 (1.02–2.53), р=0.0412) were independently associated with the risk of lethal SSICH outcome against the conservative therapy on the ground of multivariate logistic regression analysis.
Conclusions. The mathematic model for SSICH lethal outcome prediction against the conservative therapy was elaborated. It is based on results of complex clinical, neurovisualization and electroencephalographic investigations in the onset of the disease (AUC=0.99, p<0.0001; predictive accuracy 97.4 %).
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