• José L Ruiz-Sandoval, Javier Aceves-Montoya, Erwin Chiquete, Germán López-Valencia, Alejandro Lara-López, Manuel Sánchez-González, Amado Jiménez-Ruiz, Fernando Barinagarrementería, Luis Murillo-Bonilla, Antonio Arauz-Góngora, Fernando Daniel Flores-Silva, and Carlos Cantú-Brito.
• Department of Neurology, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jal.; Department of Neurosciences, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jal.; Mexico.
• Rev Invest Clin. 2022 Jan 3; 74 (1): 51-60.

BackgroundIntracerebral hemorrhage (ICH) is associated with an ominous outcome influenced by the time to hospital presentation.ObjectiveThis study aims to identify the factors that influence an early hospital arrival after ICH and the relationship with outcome.MethodsIn this multicenter registry, patients with confirmed ICH on CT scan and well-known time of symptoms onset were studied. Clinical data, arrival conditions, and prognostic scores were analyzed. Multivariate models were built to find independent predictors of < 6 h arrival (logistic regression) and in-hospital death (Cox proportional-hazards model).ResultsAmong the 473 patients analyzed (51% women, median age 63 years), the median delay since onset to admission was 6.25 h (interquartile range: 2.5-24 h); 7.8% arrived in < 1 h, 26.3% in < 3 h, 45.3% in < 6 h, and 62.3% in < 12 h. The in-hospital, 30-day and 90-day case fatality rates were 28.8%, 30.0%, and 32.6%, respectively. Predictors of arrival in < 6 h were hypertension treatment (odds ratios [OR]: 1.675, 95% confidence intervals [CI]: 1.030-2.724), ≥ 3 years of schooling (OR: 1.804, 95% CI: 1.055-3.084), and seizures at ICH onset (OR: 2.416, 95% CI: 1.068-5.465). Predictors of death (56.9% neurological) were systolic blood pressure > 180 mmHg (hazards ratios [HR]: 1.839, 95% CI: 1.031-3.281), ICH score ≥ 3 (HR: 2.302, 95% CI: 1.300-4.074), and admission Glasgow Coma Scale < 8 (HR: 4.497, 95% CI: 2.466-8.199). Early arrival was not associated with outcome at discharge, 30 or 90 days.ConclusionsIn this study, less than half of patients with ICH arrived to the hospital in < 6 h. However, early arrival was not associated with the short-term outcome in this data set.

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