Association between critical care admission and 6-month functional outcome after spontaneous intracerebral haemorrhage

Background. There is uncertainty about the clinical benefit of admission to critical care after spontaneous intracerebral haemorrhage (ICH).
Purpose. We investigated factors associated with critical care admission after spontaneous ICH and evaluated associations between critical care and 6-month functional outcome.
Methods. We included 825 patients with acute spontaneous non-traumatic ICH, recruited to a prospective multicenter observational study. We evaluated the characteristics associated with critical care admission and poor 6-month functional outcome (modified Rankin Scale, mRS > 3) using univariable (chi-square test and Wilcoxon rank-sum test, as appropriate) and multivariable analysis.
Results. 286 patients (38.2%) had poor 6-month functional outcome. Seventy-seven (9.3%) patients were admitted to critical care. Patients admitted to critical care were; younger (p<0.001), had lower GCS score (p<0.001), larger ICH volume (p<0.001), and more often had intraventricular extension (p = 0.008). They also underwent neurosurgery more frequently (p<0.001) and had a higher proportion of patients with poor functional outcome at 6 months (39/77 [50.7%] vs 286/748 [38.2%]; p = 0.034). In multivariable analysis, critical care maintained its association with a higher odds of poor functional outcome (adjusted OR 2.43 [95%CI 1.36-4.35], p=0.003).
Conclusions. Admission to critical care is associated with poor 6-month functional outcome after spontaneous ICH. Our findings provide prognostic information that can help guide critical care treatment decisions after ICH.