Effect of Glasgow Coma Scale on the choice of treatment strategy in acute hypertensive intracerebral hemorrhage

Abstract

Objective To investigate the effect of Glasgow Coma Scale (GCS) on the choice of treatment strategy in acute hypertensive intracerebral hemorrhage.  Methods Among 286 patients with hypertensive intracerebral hemorrhage, 186 patients underwent operation. According to GCS scores on admission, 186 cases included 94 cases of GCS 5-8, 71 cases of GCS 9-11 and 21 cases of GCS 12-14. These patients respectively underwent hematoma clearance and decompressive craniotomy (N = 63, 22.03%), hematoma clearance (N = 21, 7.34%), trepanation and drainage or external ventricular drainage (N = 102, 35.66%). The rest (N = 100) underwent conservative treatment, including 25 cases of GCS 5-8, 27 cases of GCS 9-11, 25 cases of GCS 12-14 and 23 cases of GCS 15. Glasgow Outcome Scale (GOS) was used to evaluate curative effect after 3-6 months follow-up.  Results The proportion of GOS in GCS 5-8 group was 14 cases (11.76%) of Grade 1, 21 cases (17.65%) of Grade 2, 39 cases (32.77%) of Grade 3, 22 cases (18.49%) of Grade 4 and 17 cases (14.29%) of Grade 5, except 6 lost cases (5.04%). The proportion of GOS in GCS 9-11 group was 6 cases (6.12%) of Grade 1, 2 cases (2.04%) of Grade 2, 6 cases (6.12%) of Grade 3, 48 cases (48.98%) of Grade 4 and 34 cases (34.69%) of Grade 5, except 2 lost cases (2.04%). The proportion of GOS in GCS 12-14 group was 15 cases (32.61%) of Grade 4 and 31 cases (67.39%) of Grade 5. The proportion of GOS in GCS 15 group was one case (4.35%) of Grade 4 and 22 cases (95.65%) of Grade 5. Differences between groups had statistical significance ( χ ² = 142.966, P = 0.000).  Conclusions The prognosis of patients with hypertensive intracerebral hemorrhage is positively related to GCS score on admission. The higher the GCS score is, the higher the GOS grade will be.

DOI: 10.3969/j.issn.1672-6731.2017.03.011