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Predictors for recurrent spontaneous intracerebral hemorrhage: A retrospective study
Catarina Castro Alves1,2,, , Hipólito Nzwalo1,2, Ana Marreiros1,2
1 Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Portugal
2 Algarve Biomedical Center, Universidade do Algarve, Portugal

Aim: The aim of this work was to determine predictors for recurrence of intracerebral hemorrhage (ICH), which may allow the identification and more appropriate management of patients at higher risk of recurrent ICH.

Introduction: The prognosis of recurrent bleeding seems to be worse than that of the first ICH. However, only a limited number of studies report the frequency of recurrence in ICH and attempt to characterize which factors may be associated with tendency for repeated hemorrhagic events.

Methods: We analyzed data from 549 patients admitted for treatment of ICH at the Unit of Faro of the Algarve Hospital Center, followed over a period of 5 years. 189 patients with a Rankin at discharge equal to 6 were excluded from the analysis.

Results: We identified 24 patients (6.7%) with recurrent ICH. Recurrence was significantly more frequent in woman (10.9%) then in men (4.4%) (p<0.05). By comparing patients with recurrent ICH with patients with isolated ICH, we found that recurrence was associated with more advanced ages at the time of the first ICH, but only for men (76 years for recurrent ICH and 68 years for isolated ICH) (p<0.05). There was a tendency towards recurrence when the bleeding was lobar (33% of recurrence, and 24% for non-lobar bleedings), although no statistical significance could be found. Other factors, such as previous hypertension were not associated with increased risk of recurrent ICH.

Conclusion: In this series of patients, we identified sex and age as predictors for ICH recurrence.

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