22. European Stroke Conference 105 Stroke prognosis CEREBELLAR HEMORRHAGE. PROGNOSTIC FACTORS AND LONG-TERM OUT-COME. 336 © 2013 S. Karger AG, Basel Scientific Programme M. REYES1, A. ARAUZ2, A. RIVERA3, P. ROJAS4 Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez., Mexico City, MEXICO1, Stroke Clinic, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez., Mexico City, MEXICO2, Stroke Clinic, National Institute of Neurology and Neuro-surgery Manuel Velasco Suárez., Mexico City, MEXICO3, Stroke Clinic, National Institute of Neu-rology and Neurosurgery Manuel Velasco Suárez., Mexico City, MEXICO4 Background. Cerebellar hemorrhage represents 5 to 15% of all intracerebral hemorrhages. The long-term outcome of patients with cerebellar hemorrhage has not been described successfully. The aim of this study was to determine the long-term outcome in Mexicans patients following medical and/or surgical treatment and to identify possible prognostic factors. Methods. This was a single center registry on the clinical outcome of Mexican patients with cerebel-lar hemorrhage that was carried out between May1980 to December 2011. Cerebellar hemorrhage was classified in 1) hemispheric 2) vermian, 3) hemispheric+vermian. The treatment was catego-rized into a) medical and b) surgical, functional outcome was assessed by modified Rankin Scale (mRS). We analyzed clinical and radiological findings and the long-term outcome, and we compared between these groups to identify possible prognostic factors. Results. The study included 89 patients (aged 53.4+/-19.2 years), 45 men. The main risk factors were: hypertension (54%), diabetes mellitus (20%) and smoking (20%). Cerebellar hematoma was located hemispheric in 59 patients (66.3%), vermian in 13 (14.6%) and hemispheric+vermian in 17 (19.1%). Between the treatment groups there were no differences with respect sex, aetiology, age, smoking, localization, history of hypertension or diabetes. Glasgow Coma Score < 8 (GCS), hydro-cephalus, deformed fourth ventricle, compression of brainstem, ventricular hemorrhage were more frequently seen in the surgical group. At the follow-up, 20 patients died. After a mean follow-up of 31 months, 42 (47%) patients had a good functional outcome (mRS 0-2) and 27(32.5%) patients had poor functional outcome (mRS 3-5). Of the 34(38.2%) surgically patients outcome was good (mRS 0-2) in 10(29.4%) patients, 14 (41%) were severely disabled (mRS 3-5) and 10 (29.4%) patients died. Poor prognostic factors were age > 50 years, surgical management, hydrocephalus, compres-sion of brainstem and GCS < 8. Conclusions. Patients with cerebellar hemorrhage that had GCS <8, hydrocephalus, compression of brainstem with surgical management had a poor functional long-term outcome. 106 Stroke prognosis Stroke and renal function: relationship with risk factors and discharge outcomes A.M. Rowat1, C. Graham2, M.S. Dennis3 Edinburgh Napier University, Edinburgh, UNITED KINGDOM1, University of Edinburgh, Ed-inburgh, UNITED KINGDOM2, University of Edinburgh, Edinburgh, UNITED KINGDOM3 Background: Impaired renal function has been linked to stroke occurrence, but the association of a low estimated glomerular filtration rate (eGFR) after stroke with outcomes is less clear. The aim of this study was to determine the frequency of a low eGFR on admission after stroke, and its associa-tions with possible risk factors and outcomes at hospital discharge. Methods: We linked clinical data from stroke patients in two prospective hospital registers between 2005 and 2008. The eGFR was derived from a laboratory creatinine level and calculated using the Modification of Diet in Renal Disease (MDRD) method. We defined eGFR <60 mL/Min/1.73 m2 as low. Results: Of 2520 patients who had eGFR measured on admission hospital, 805 (32%) had a low eGFR. On univariate analysis, patients with renal dysfunction were significantly more likely to be dead or require institutional care at the end of their hospital admission than those without (Chi-square= 53.24, df=3, P<0.0001). On multivariate analysis, low eGFR was significantly less likely in men (OR 0.68, 95% CI 0.57 to 0.81), in patients with intracerebral haemorrhage (OR 0.62, 95% CI 0.47 to 0.82) and in those with a predicted good outcome (OR 0.27, 95% CI 0.21, 0.36) based on the Six Simple Variable (SSV) model which has been widely validated. However, a low eGRF was more likely in those prescribed diuretics (OR 1.88, 95% CI 1.47 to 2.4). Conclusion: Our findings suggest that renal dysfunction on admission is common and associated with poor outcomes. Further work is required to establish if these associations are causal and if pre-venting or treating impaired renal function improves outcomes.
Karger_ESC London_2013
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