**2. Material and methods**

We performed a descriptive study of ICH in our hospital. A convenience sample of the consultations for ICH made during shift # 1 at the ER between January 2016 and December 2018 was analyzed. All patients were evaluated and diagnosed by AS in the ER. Due to the huge number of stroke patients diagnosed in the ER of the HHHA (about 220 cases of ICH per year), it was not possible to access to the clinical data of all patients with ICH in the period. We collected clinical, biodemographic, and imaging data. The radiological data were reviewed in all cases by a neuroradiologist (MP) unblinded to the clinical data. The cases were allocated to either spontaneous ICH or secondary to vascular malformation (arteriovenous malformation, cerebral saccular aneurysm, or cavernous angioma), tumor, or anticoagulants. On the other hand, the cases were classified according to one of two possible locations: supra- or infratentorial. Supratentorial hemorrhages included lobar, basal ganglia, and thalami locations. Infratentorial hemorrhages included the brainstem or cerebellum. The volume of the hematoma was calculated using the formula ABC/2, where A is the greatest diameter of the hematoma on the slice with the largest diameter, B is the diameter of the hematoma on the axis perpendicular to A, and C is the number of axial slices in which the hematoma is visible, multiplied by the slice thickness [35].

The continuous variables were described with measures of central tendency and dispersion, mean ± standard deviation (SD), and/or medians with percentiles 25–75 (P25–P75). The STATA 14.2 software was used for the data analysis.

## **3. Results**

There were 108 consultations for ICH in the period. The average age of the patients was 66.0 years (SD = 14.1). 56.5% of the patients were male. The median NIHSS was 14 points. The median time to arrival to the ER was 4 h and 45 min. The median ICH score at admission was 1 point. Only 39.8% of patients were admitted in the ICU. The mortality at 30 days was 30.6%. This value was equivalent with in-hospital mortality. The clinical and biodemographic characteristics of the ICH patients are shown in **Table 2**. The radiological characteristics of patients are shown in **Table 3**.

**53**

**4. Discussion**

In our study we found several similarities with many papers about ICH. In our series the mean age of the patients was 66 years old. The same was reported by Hemphill et al. (66 ± 15 years) but is higher than the age reported by Lavados et al. in the PISCIS Study (57.3 ± 17 years) [13, 31]. This difference could be explained because we used a convenience sample with cases that were not included consecutively. In our series we included about 1/6 of the ICH cases diagnosed in the ER of HHHA (about 220 cases/year). On the other hand, the locations found were similar to the findings of Hemphill et al.: 81.5%

*Clinical and biodemographic characteristics of patients with intracerebral hemorrhage Hospital Dr. Hernán* 

*Epidemiology and Management of Intracerebral Hemorrhage in Chile*

**Characteristics Patients (N = 108)**

≥65 years (%) 55.6 ≥80 years (%) 17.6 Male sex (%) 56.5 Mapuche ethnicity (%) 27.8 Rurality (%) 38.0 Temuco (%) 35.2

) 66.0 (14.1)

 (median, P25–P75) 14.0 (5–20) Time to arrival (median, P25–P75) [min] 4 h 45′(3 h–14 h 21′) Time to triage (median, P25–P75) 8 min (5–15) Time to evaluation (median, P25–P75) 34 min (17–78)

 score (median, P25–P75) 1 (1–3) ICH score (%) 0 = 23.1

Surgical hematoma evacuation (%) 3.1

placement (%) 2.1

30-day 30.6 90-day 32.4 180-day 37.0 Destination (%) Intensive care unit = 39.8

1 = 32.7 2 = 15.4 3 = 14.4 4 = 12.5 5 = 1.9

Internal medicine service = 32.4 Other hospital =24.1 Dye = 2.8 Discharge = 0.9

*DOI: http://dx.doi.org/10.5772/intechopen.86312*

Age (SDa

NIHSSb

ICHc

EVDd

*a*

*b*

*c*

*d*

**Table 2.**

Mortality (%)

*Standard deviation.*

*Intracerebral hemorrhage.*

*External ventricular drain.*

*National Institute of Health Stroke Scale.*

*Henríquez Aravena, Temuco, Chile, in 2016–2018.*


## *Epidemiology and Management of Intracerebral Hemorrhage in Chile DOI: http://dx.doi.org/10.5772/intechopen.86312*

**Table 2.**

*Aging - Life Span and Life Expectancy*

CI = 3.23–11.04) [34].

**2. Material and methods**

inhabitants. Most patients with ICH stay a long time (24–48 h) in the ER waiting for a bed in the ICU. In these conditions it is very difficult to provide the standard care to these patients, including intensive blood pressure management and general neuroprotection. Based on the results of INTERACT2 and ATACH-2 studies, our target for systolic blood pressure in the first 48 h is less than 140 mmHg [32, 33]. Intravenous labetalol and nitroglycerin are the drugs more frequently used.

Another issue is the delay for the presentation of ICH patients. In a recent study, we estimated a median of 4 h and 45 mins (P25–P75 = 3 h 13′–14 h 16′) for arrival to the ER. Just 17.4% of patients with ICH arrived in less than 3 h. In a chi-square test, the variables associated with a presentation in under 3 h were living in Temuco-PLC (p < 0.01), urban origin (p = 0.02), arrival by own car (p = 0.032), and severity (NIHSS ≥7) (p < 0.01). In a logistic regression model, only living in Temuco-PLC and severity were statistically significant with a combined odds ratio of 5.97 (95%

The objective of this chapter is to report the experience in the treatment of

We performed a descriptive study of ICH in our hospital. A convenience sample of the consultations for ICH made during shift # 1 at the ER between January 2016 and December 2018 was analyzed. All patients were evaluated and diagnosed by AS in the ER. Due to the huge number of stroke patients diagnosed in the ER of the HHHA (about 220 cases of ICH per year), it was not possible to access to the clinical data of all patients with ICH in the period. We collected clinical, biodemographic, and imaging data. The radiological data were reviewed in all cases by a neuroradiologist (MP) unblinded to the clinical data. The cases were allocated to either spontaneous ICH or secondary to vascular malformation (arteriovenous malformation, cerebral saccular aneurysm, or cavernous angioma), tumor, or anticoagulants. On the other hand, the cases were classified according to one of two possible locations: supra- or infratentorial. Supratentorial hemorrhages included lobar, basal ganglia, and thalami locations. Infratentorial hemorrhages included the brainstem or cerebellum. The volume of the hematoma was calculated using the formula ABC/2, where A is the greatest diameter of the hematoma on the slice with the largest diameter, B is the diameter of the hematoma on the axis perpendicular to A, and C is the number of axial slices in which

The continuous variables were described with measures of central tendency and dispersion, mean ± standard deviation (SD), and/or medians with percentiles 25–75

There were 108 consultations for ICH in the period. The average age of the patients was 66.0 years (SD = 14.1). 56.5% of the patients were male. The median NIHSS was 14 points. The median time to arrival to the ER was 4 h and 45 min. The median ICH score at admission was 1 point. Only 39.8% of patients were admitted in the ICU. The mortality at 30 days was 30.6%. This value was equivalent with in-hospital mortality. The clinical and biodemographic characteristics of the ICH patients are shown in **Table 2**. The radiological characteristics of patients are

patients with ICH in a regional public hospital in Temuco, Chile.

the hematoma is visible, multiplied by the slice thickness [35].

(P25–P75). The STATA 14.2 software was used for the data analysis.

**52**

**3. Results**

shown in **Table 3**.

*Clinical and biodemographic characteristics of patients with intracerebral hemorrhage Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile, in 2016–2018.*
