Association of Clinical Scores and Cardiac Troponin I with 30-Day Mortality in Patients with Spontaneous Intracerebral Hemorrhage

TL;DR

This study examines how clinical scores and cardiac troponin I levels relate to 30-day mortality in patients with spontaneous brain hemorrhage.

Contribution

The study evaluates the role of hs-cTnI as a potential prognostic marker in sICH patients alongside established clinical scores.

Findings

Higher ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and IVH were associated with increased 30-day mortality.

Serum hs-cTnI levels correlated with worse clinical parameters but were not independent predictors of mortality in multivariate analysis.

Larger multicenter studies are needed to clarify the clinical utility of hs-cTnI in sICH management.

Abstract

Background/Objectives: Spontaneous intracerebral hemorrhage (sICH) is a particularly severe subtype of stroke, characterized by high rates of mortality and long-term disability, for which robust prognostic markers are still lacking. The aim of this study was to assess the relationship of the ICH score, the National Institutes of Health Stroke Scale (NIHSS) score, and serum high-sensitivity cardiac troponin I (hs-cTnI) levels with 30-day mortality in patients with sICH. Methods: We conducted a prospective observational cohort study enrolling 100 consecutive patients diagnosed with sICH based on neuroimaging findings. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed. Results: Patients who died were older and had significantly higher ICH and NIHSS scores, lower Glasgow Coma Scale (GCS) scores, larger hematoma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared to survivors. Serum hs-cTnI concentrations were significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, higher ICH score, NIHSS score, and hs-cTnI level were associated with mortality, whereas multivariate analysis identified the GCS score, hematoma volume, and IVH score as significant independent factors related to fatal outcome. Conclusions: Individual components of the ICH score may provide useful information on outcomes in patients with sICH. Higher serum hs-cTnI levels were associated with 30-day mortality but were not independent predictors. These markers may assist in patient monitoring and support established clinical procedures in therapeutic decision-making. Nevertheless, larger multicenter studies are needed to further clarify their clinical implications in sICH management.

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