Early identification and management of IVH are crucial for improving outcomes in SICH patients

Oct 13, 2025 by wbrum.org 10 views

The Relationship Between Intraventricular Bleeding and 30-Day Mortality in Sufferers of Spontaneous Intracerebral Hemorrhage

Introduction

Spontaneous intracerebral hemorrhage (SICH) is a type of stroke that occurs when a blood vessel in the brain ruptures, causing bleeding into the surrounding brain tissue. Intraventricular hemorrhage (IVH) is a complication of SICH that occurs when bleeding extends into the ventricles of the brain, which can lead to increased intracranial pressure and mortality. This study aims to investigate the relationship between IVH and 30-day mortality in patients with SICH.

Background

SICH is a leading cause of death and disability worldwide, with a high mortality rate within the first 30 days of onset. Intraventricular hemorrhage is a significant predictor of mortality in SICH patients, and early identification of IVH is crucial for timely intervention and improved outcomes. However, the relationship between IVH and 30-day mortality in SICH patients is not well understood, and further research is needed to clarify this association.

Methodology

This study used a cross-sectional design and was conducted at the H. Adam Malik Central General Hospital in Medan, Indonesia, from January 2011 to August 2013. A total of 100 patients with SICH were included in the study, with an onset of bleeding less than 48 hours and meeting the inclusion criteria. The research team evaluated IVH based on CT scans of the head and used three assessment systems: IVH Score, Graeb Score, and Leroux Score to assess the severity of IVH. The results were then analyzed by looking at the patient's 30-day mortality rate.

Results

The results showed that the volume of bleeding and Graeb Score had a significant association with 30-day mortality, with a p-value of 0.06. This indicates that patients with large bleeding volumes and high Graeb Scores are at increased risk of mortality within 30 days. The IVH Score and Glasgow Coma Scale (GCS) also showed a significant association with 30-day mortality, with p-values of 0.09. Among the three score systems, Graeb Score had the highest significance value for 30-day mortality, followed by IVH Score and Leroux Score. The volume of bleeding had the highest significance value (p = 0.34) for 30-day mortality compared to other variables.

Discussion

This study reveals that intraventricular bleeding, especially the volume of bleeding and Graeb Score, has a significant relationship with 30-day mortality in sufferers of SICH. This highlights the importance of early identification and management of IVH in SICH patients. The Graeb Score Assessment System can be an effective tool in predicting the risk of death in SICH patients with IVH. Furthermore, this study emphasizes the need for special attention to the volume of bleeding in SICH patients, as large volumes increase the risk of death.

Limitations

This study has several limitations, including a limited sample size and no data on other risk factors that may affect mortality. Further research with a stronger design is needed to confirm this result and explore a deeper understanding of the role of intraventricular bleeding in the mortality of patients with SICH.

Conclusion

In conclusion, this study demonstrates a significant relationship between intraventricular bleeding and 30-day mortality in sufferers of SICH. The Graeb Score Assessment System can be a useful tool in predicting the risk of death in SICH patients with IVH. Early identification and management of IVH are crucial for improving outcomes in SICH patients. Further research is needed to confirm these findings and explore the role of intraventricular bleeding in the mortality of patients with SICH.

Recommendations

Based on the findings of this study, the following recommendations are made:

Early identification and management of IVH are crucial for improving outcomes in SICH patients.
The Graeb Score Assessment System can be a useful tool in predicting the risk of death in SICH patients with IVH.
Special attention should be given to the volume of bleeding in SICH patients, as large volumes increase the risk of death.
Further research with a stronger design is needed to confirm these findings and explore the role of intraventricular bleeding in the mortality of patients with SICH.

Future Directions

Future research should aim to:

Confirm the findings of this study using a larger sample size and stronger design.
Explore the role of other risk factors that may affect mortality in SICH patients.
Develop and validate new assessment systems for predicting the risk of death in SICH patients with IVH.
Investigate the effectiveness of early intervention and management strategies for IVH in SICH patients.

References

[List of references cited in the study]

Appendix

[Appendix materials, including additional tables and figures]
Frequently Asked Questions: The Relationship Between Intraventricular Bleeding and 30-Day Mortality in Sufferers of Spontaneous Intracerebral Hemorrhage

Q: What is spontaneous intracerebral hemorrhage (SICH)?

A: SICH is a type of stroke that occurs when a blood vessel in the brain ruptures, causing bleeding into the surrounding brain tissue.

Q: What is intraventricular hemorrhage (IVH)?

A: IVH is a complication of SICH that occurs when bleeding extends into the ventricles of the brain, which can lead to increased intracranial pressure and mortality.

Q: What is the significance of IVH in SICH patients?

A: IVH is a significant predictor of mortality in SICH patients, and early identification of IVH is crucial for timely intervention and improved outcomes.

Q: What is the relationship between IVH and 30-day mortality in SICH patients?

A: This study found that the volume of bleeding and Graeb Score had a significant association with 30-day mortality, with a p-value of 0.06. This indicates that patients with large bleeding volumes and high Graeb Scores are at increased risk of mortality within 30 days.

Q: What is the Graeb Score Assessment System?

A: The Graeb Score Assessment System is a tool used to assess the severity of IVH. It has been shown to be a useful predictor of mortality in SICH patients with IVH.

Q: What are the limitations of this study?

A: This study has several limitations, including a limited sample size and no data on other risk factors that may affect mortality. Further research with a stronger design is needed to confirm these findings and explore the role of intraventricular bleeding in the mortality of patients with SICH.

Q: What are the recommendations for SICH patients with IVH?

A: Based on the findings of this study, the following recommendations are made:

Early identification and management of IVH are crucial for improving outcomes in SICH patients.
The Graeb Score Assessment System can be a useful tool in predicting the risk of death in SICH patients with IVH.
Special attention should be given to the volume of bleeding in SICH patients, as large volumes increase the risk of death.
Further research with a stronger design is needed to confirm these findings and explore the role of intraventricular bleeding in the mortality of patients with SICH.

Q: What are the future directions for research on SICH and IVH?

A: Future research should aim to:

Confirm the findings of this study using a larger sample size and stronger design.
Explore the role of other risk factors that may affect mortality in SICH patients.
Develop and validate new assessment systems for predicting the risk of death in SICH patients with IVH.
Investigate the effectiveness of early intervention and management strategies for IVH in SICH patients.

Q: What can patients and families do to reduce the risk of mortality in SICH patients with IVH?

A: Patients and families can take the following steps to reduce the risk of mortality in SICH patients with IVH:

Seek immediate medical attention if symptoms of SICH occur.
Follow the treatment plan recommended by the healthcare team.
Monitor the patient's condition closely and report any changes to the healthcare team.
Participate in rehabilitation and follow-up care to improve outcomes.

Q: Where can patients and families find more information on SICH and IVH?

A: Patients and families can find more information on SICH and IVH from reputable sources, such as:

National Institute of Neurological Disorders and Stroke (NINDS)
American Heart Association (AHA)
American Stroke Association (ASA)
Local hospitals and healthcare organizations.