Determinants of early outcome in spontaneous lobar cerebral hemorrhage

Objective-To identify determinants of early outcome in spontaneous lobar hemorrhage. Materials and methods-From 2500 acute stroke patients included in a prospective hospital-based stroke registry over a 12-year period, 97 cases of lobar hematoma were selected. Determinants of in-hospital mortality were studied in multiple regression models. Results-Lobar hematomas accounted for 3.9% of all acute stroke patients and 35.9% of intracerebral hemorrhages. The presence of chronic obstructive pulmonary disease (COPD) was a significant predictive variable in the model based on demographic variables and vascular risk factors [odds ratio (OR): 17.18; 95% CI: 1.77-166.22] and in the model based on these variables plus clinical data (OR: 15.12; 95% CI: 1.27-179.59). Other predictive variables included altered consciousness, previous cerebral infarct and chronic liver disease. Conclusions-COPD appeared as the most important predictor of death during hospitalization after lobar cerebral hemorrhage, a finding not generally acknowledged earlier.