Long-term outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage

OBJECTIVETo evaluate long-term survival and functional outcome in intensive care unit survivors after mechanical ventilation for intracerebral hemorrhage. DESIGNRetrospective chart review and prospective follow-up study. SETTINGOutpatient follow-up. PATIENTSBetween 1997 and 2000, 120 patients were mechanically ventilated for an intracerebral hemorrhage at our intensive care unit. Sixty-two patients were discharged from hospital (in-hospital mortality = 48%). Sixty patients were evaluated for survival and functional outcome (two were lost to follow-up). Time between discharge and follow-up was ≥1 yr and was a mean of 27 ± 14 months (range, 12–56). INTERVENTIONSNone. MEASUREMENTS AND MAIN RESULTSPatients’ physicians were first asked about survival, and patients or proxies were interviewed by phone. Barthel Index and modified Rankin Scale scores were collected, and demographic information and general data were reviewed. The estimated life-table survival curve after discharge was 64.6% at 1 yr and 57% at 3 yrs. In the 24 patients who died, the mean time between discharge and death was 5 ± 6 months. Probability of death after discharge significantly increased if age at admission was >65 yrs (p < .01; odds ratio, 3.5; 95% confidence interval, 1.4–9.1) and if Glasgow Coma Scale score at discharge was 2). CONCLUSIONSProbability of survival at 3 yrs after mechanical ventilation for an intracerebral hemorrhage was >50%. Age was an important determinant of long-term survival. Forty-two percent of long-term survivors were independent for activities of daily living. Only a few long-term survivors had a very high degree of disability.