Spontaneous intracerebral hemorrhage in Mexico: results from a Multicenter Nationwide Hospital-based Registry on Cerebrovascular Disease (RENAMEVASC)
José L Ruiz-Sandoval, Erwin Chiquete, Alejandra Gárate-Carrillo, Ana Ochoa-Guzmán, Antonio Arauz, Carolina León-Jiménez, Karina Carrillo-Loza, Luis M Murillo-Bonilla, Jorge Villarreal-Careaga, Fernando Barinagarrementería, Carlos Cantú-Brito, RENAMEVASC investigators, C Cantú-Brito, A Arauz, L M Murillo-Bonilla, L Hoyos, J L Ruiz-Sandoval, E Chiquete, J Villarreal-Careaga, F Guzmán-Reyes, F Barinagarrementería, J A Fernández, B Torres, C León-Jiménez, I Rodríguez-Leyva, R Rangel-Guerra, M Baños, L Espinosa, M de la Maza, H Colorado, M C Loy-Gerala, J Huebe-Rafool, G Aguayo-Leytte, G Tavera-Guittings, V García-Talavera, O Ibarra, M Segura, J L Sosa, O Talamás-Murra, M Alanis-Quiroga, J M Escamilla, M A Alegría, J C Angulo, José L Ruiz-Sandoval, Erwin Chiquete, Alejandra Gárate-Carrillo, Ana Ochoa-Guzmán, Antonio Arauz, Carolina León-Jiménez, Karina Carrillo-Loza, Luis M Murillo-Bonilla, Jorge Villarreal-Careaga, Fernando Barinagarrementería, Carlos Cantú-Brito, RENAMEVASC investigators, C Cantú-Brito, A Arauz, L M Murillo-Bonilla, L Hoyos, J L Ruiz-Sandoval, E Chiquete, J Villarreal-Careaga, F Guzmán-Reyes, F Barinagarrementería, J A Fernández, B Torres, C León-Jiménez, I Rodríguez-Leyva, R Rangel-Guerra, M Baños, L Espinosa, M de la Maza, H Colorado, M C Loy-Gerala, J Huebe-Rafool, G Aguayo-Leytte, G Tavera-Guittings, V García-Talavera, O Ibarra, M Segura, J L Sosa, O Talamás-Murra, M Alanis-Quiroga, J M Escamilla, M A Alegría, J C Angulo
Abstract
Introduction: Scarce information exists on intracerebral hemorrhage (ICH) in Latin America, and the existent is derived from single-center registries with non-generalizable conclusions. The aim of this study is to describe the frequency, etiology, management and outcome of ICH in Mexico.
Patients and methods: We studied consecutive patients with ICH pertaining to the National Multicenter Registry on Cerebro-vascular Disease (RENAMEVASC), conducted in 25 centers from 14 states of Mexico. The Intracerebral Hemorrhage Grading Scale (ICH-GS) at admission was used to assess prognosis at 30 days follow-up.
Results: Of 2,000 patients with acute cerebrovascular disease registered in RENAMEVASC, 564 (28%) had primary ICH (53% women; median age: 63 years; interquartile range: 50-75 years). Hypertension (70%), vascular malformations (7%) and amyloid angiopathy (4%) were the main etiologies. In 10% of cases etiology could not be determined. Main ICH locations were basal ganglia (50%), lobar (35%) and cerebellum (5%). Irruption into the ventricular system occurred in 43%. Median score of ICH-GS was 8 points: 49% had 5-7 points, 37% had 8-10 points and 15% had 11-13 points. The 30-day case fatality rate was 30%, and 31% presented severe disability. The 30-day survival was 92% for patients with ICH-GS 5-7 points, whereas it decreased to 27% in patients with ICH-GS 11-13 points.
Conclusions: In Mexico, ICH represents about a third of the forms of acute cerebrovascular disease, and the majority of patients present severe disability or death at 30 days of follow-up. Hypertension is the main cause; hence, control of this important cardiovascular risk factor should reduce the health burden of ICH.
Source: PubMed