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A Prognostic Model of Pontine Hemorrhage Based on Hemorrhage Volume and Location

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Abstract
Objective
Spontaneous pontine hemorrhages have the highest mortality rate. Posterior pontine hemorrhage has a poor prognosis, although more research is required in this area. Herein, we attempted to determine the prognosis of pontine hemorrhage by schematically illustrating the volume and location and developing a scoring model to predict the relationship between initial hemorrhage characteristics and clinical outcome.
Methods
This multicenter, retrospective study was conducted between January 2010 and December 2019. We developed a scoring model using computed tomography (5-mm sections) to plot the location and volume of pontine hemorrhages. All hemorrhage volumes were classified as mild (0.5?5 cm3), moderate (5?10 cm3), or severe (10?16 cm3).
Results
As the pontine hemorrhage volume increased, the Glasgow Coma Scale (GCS) and Eastern Cooperative Oncology Group scores (ECOG) were significantly lower, while the modified Rankin Scale (mRS) was higher (p<0.001). In the mild and moderate groups, the GCS recovered from 11.36 to 12.89 and 4.68 to 7.31 over 24 months, respectively. The mRS improved from 3.25 to 2.82 in the mild hemorrhage group but deteriorated in the moderate hemorrhage group from 4.93 to 5.24 over 24 months. More extensive pontine hemorrhages were associated with shorter life expectancy. The mild, moderate, and severe groups showed 32.79%, 89.29%, and 100% mortality, respectively (p<0.0001). The anterior and posterior hemorrhage groups had 69.44% and 42.86% mortality (p=0.0020), respectively.
Conclusion
According to our prognosis model, initial hemorrhage volume was the most significantly related neurological outcome. Hemorrhage location showed no relationship with neurological outcome. However, anterior upper pontine hemorrhage volume was correlated with shortened survival time.
Author(s)
김민한조수희유승훈박지은박원형박중철안재성김모이네이승주
Issued Date
2021
Type
Article
Keyword
Prognostic model of pontine hemorrhagePrognosis of pontine hemorrhageAnterior and posterior pontine hemorrahgeNeurologic outcome of pontine hemorrhage
DOI
10.14730/aaps.2021.00339
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7933
Publisher
Journal of Neurointensive care
Location
대한민국
Language
한국어
Citation Volume
4
Citation Number
1
Citation Start Page
21
Citation End Page
29
Appears in Collections:
Medicine > Medicine
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