Functioning of long-term survivors of first-ever intracerebral hemorrhage

• Published in: Acta neurologica Scandinavica Vol. 129; no. 4; pp. 269 - 275
• Main Authors: Tveiten, A., Ljøstad, U., Mygland, Å., Naess, H.
• Format: Journal Article
• Language: English
• Published: Denmark Blackwell Publishing Ltd 01.04.2014; Hindawi Limited
• Subjects: Aged; Aged, 80 and over; Analysis of Variance; Cerebral Hemorrhage - mortality; Cerebral Hemorrhage - physiopathology; Cognition Disorders - diagnosis; Cognition Disorders - etiology; Cognitive ability; cognitive impairment; Cohort Studies; Female; functional outcome; Hemorrhage; Humans; intracerebral hemorrhage; leukoaraiosis; Male; Severity of Illness Index; stroke; Treatment Outcome
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/ane.12185

Objectives There are few data on long‐term functional outcome after intracerebral hemorrhage (ICH). We aimed to assess functional dependency and cognitive impairment in long‐term survivors of first‐ever intracerebral hemorrhage. Materials and methods Between August and November 2011, we contacted all survivors from a cohort of 134 consecutive patients hospitalized with a first‐ever ICH in the period 2005–2009 in a well‐defined catchment area. We did an extensive face‐to‐face follow‐up including the National Institute of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), the Barthel Index (BI), and the Montreal Cognitive Assessment (MoCA). Results Fifty‐one patients (38%) were alive. Fifty agreed to take part in the follow‐up. The median follow‐up time was 3.8 years. Thirty‐four patients (68%) were independent (mRS 0–2) and 16 (32%) dependent (mRS 3–5). Factors independently associated with dependency were leukoaraiosis score (OR 2.3 per increasing point, P = 0.003) and female sex (OR 5.1, P = 0.038). Twenty‐seven patients (61%) had cognitive impairment (MoCA ≤ 23). Factors independently associated with cognitive impairment were age (OR 2.4 per 10 years, P = 0.010) and lobar ICH location (OR 14.1, P = 0.016). Conclusions A large proportion of long‐term survivors of ICH in Southern Norway live functionally independent lives in their private homes. Dependency is linked to leukoaraiosis and female sex. Cognitive impairment is common and linked to lobar location of ICH.