How Patients Die After Intracerebral Hemorrhage

• Published in: Neurocritical care 2009-08, Vol.11 (1), p.45-49
• Main Authors: Naidech, Andrew M., Bernstein, Richard A., Bassin, Sarice L., Garg, Rajeev K., Liebling, Storm, Bendok, Bernard R., Batjer, H. Hunt, Bleck, Thomas P.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain Death; Cardiac arrest; Cause of Death; Cerebral Hemorrhage - mortality; Critical Care - statistics & numerical data; Critical Care Medicine; Death; Ethnicity; Euthanasia, Passive - statistics & numerical data; Female; Glasgow Coma Scale; Hemorrhage; Humans; Intensive; Internal Medicine; Life Support Care - statistics & numerical data; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Mortality; Neurology; Original Article; Patients; Perceptions; Pneumonia; Prospective Studies; Resuscitation Orders; Severity of Illness Index; Stroke
• ISSN: 1541-6933; 1556-0961
• DOI: 10.1007/s12028-009-9186-z

Introduction Severity of illness scores predict all-cause mortality after intracerebral hemorrhage (ICH), but do not differentiate between proximate mechanisms or predict the timing. We hypothesized that death by neurologic criteria [brain death (BD)], withdrawal of life support, and cardiovascular death would be distinct after ICH. Methods We prospectively enrolled patients with spontaneous ICH without underlying vascular malformation or neoplasm. We recorded clinical data and the proximate mechanism of death (BD, withdrawal of life support, cardiovascular death, or other cause). Time to death was compared with Kaplan–Meier methods (log-rank test). Data are median (IQR). Results Among 89 patients, 15 had withdrawal of life support, 5 had BD, 2 died from cardiac arrest, and 3 died from other causes. Among patients who died, ICH score, age, Glasgow Coma Scale, NIH Stroke Scale, and proximate cause were not associated with the proximate mechanism of death. The time to death was different ( P