• Chonnawee Chaisawasthomrong and Kriangsak Saetia.
• Division of Neurosurgery, Department of Surgery, Ratchaburi Hospital, Ratchaburi, Thailand.
• World Neurosurg. 2024 Apr 1; 184: e774e783e774-e783.

ObjectiveThis study aims to investigate independent factors associated with 30-day mortality in patients with acute spontaneous intracerebral hemorrhage (SICH) before treatment.MethodsA retrospective analysis was performed on medical records of patients hospitalized with acute SICH between 2019 and 2021. Data included personal history, hospital stay duration, symptom onset, chief complaint, underlying diseases, medication, and alcohol/smoking habits. Physical examination records comprised baseline blood pressure, Glasgow Coma Scale assessment, and pupil reaction evaluation. Diagnostic imaging, specifically computed tomography brain scans, was examined for hemorrhage details. Multivariable logistic analysis was utilized for data analysis.ResultsAmong 663 cases, 185 (27.9%) experienced mortality. Risk factors for mortality included chronic kidney disease, ischemic heart disease, loss of follow-up in hypertension clinic, and pontine hemorrhage. Conversely, motor response (m), reactive pupils, and basal cistern persistence significantly decreased the risk of mortality in multivariable analysis. Receiver operating characteristic analysis identified a m score of 5 as the cutoff for predicting survival.ConclusionsChronic kidney disease, ischemic heart disease, loss of hypertension follow-up, m, reactive pupils, pontine hemorrhage, and basal cistern persistence were independent variables associated with the 30-day mortality rate in SICH patients before treatment initiation. A m, pupil reaction, and basal cistern persistence serve as predictive tools for assessing mortality in SICH before treatment.Copyright © 2024 Elsevier Inc. All rights reserved.

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