Short-Term Hospital Outcome in Patients with Spontaneous Intracerebral Hemorrhage Based on Admission Hyponatremia

Background: Spontaneous intracerebral haemorrhage (S-ICH) is a life-threatening neurological emergency with high morbidity and mortality. Admission hyponatremia, commonly resulting from syndrome of inappropriate antidiuretic hormone secretion (SIADH), is frequently observed in S-ICH patients and may negatively impact outcomes. Aim of the Study: The aim of this study was to predict the short-term hospital outcome in patients with spontaneous intracerebral haemorrhage on the basis of admission hyponatremia. Methods: This hospital based observational study was conducted in Department of Neurology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January, 2015 to December, 2016. Total 100 patients with spontaneous intracerebral haemorrhage were included in this study. Result: Most of the patients were over 60 years old (75%), with majority (57%) being male. Hypertension was common (68%) and smoking was a major risk factor among males (64.9%). Headache (82%) and hemiparesis or hemiplegia (73%) were the most frequent presenting features, followed by vomiting (62%) and altered consciousness (30%). Convulsions were rare (9%). At two weeks, 62% of patients had disability (mRS >2), and 18% had died. Patients with serum sodium <135 mmol/L had higher rates of low GCS, larger hematoma volume and infratentorial bleed, though not statistically significant. However, they showed significantly higher disability (85%) and mortality (40%) compared to those with normal sodium, with relative risks of 1.51 and 3.20, respectively. Conclusion: The current study concludes that admission hyponatremia is associated with higher proportion of disability (mRS>2) at the end of second week after onset and higher mortality within this period in patients with spontaneous intracerebral haemorrhage.