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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Spontaneous intracerebral haemorrhage &#40;SICH&#41; is a prevalent disease&#46; It is the second leading cause of acute cerebrovascular accident &#40;ACVA&#41;&#44; accounting for about 10&#8211;15&#37; of the total&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> The significance of SICH lies in its high rates of morbidity and mortality in a young adult population&#44; with mortality rates ranging from 30&#37; to 50&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to neurological complications&#44; these patients often develop multiple systemic complications and&#44; as we also have to consider it a clinical process with different standardised phases of action&#44; specialised multidisciplinary management is required&#46; Management of SICH in the intensive care unit &#40;ICU&#41; and the involvement of the intensive medicine specialist and neurosurgeon in conjunction with other specialists constitute standard practice for this disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However&#44; the poor outcomes sometimes lead to a sense of futility about the measures applied&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Our <span class="elsevierStyleItalic">objective</span> was to analyse the changes over more than 20 years in the presenting features&#44; outcomes and treatment in the ICU&#44; and in functional prognosis at 12 months after SICH treated in the ICU of a referral hospital&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was a descriptive&#44; retrospective study in a tertiary level hospital&#44; a referral hospital for neurosurgical patients where only multiple trauma and neurocritical patients are treated&#46; Information was collected on all admissions of patients with SICH in three periods&#58; 1999&#8211;2001 &#40;period I&#41;&#59; 2015&#8211;2016 &#40;period II&#41;&#59; and 2020&#8211;2021 &#40;period III&#41;&#46; Demographic variables&#44; baseline patient characteristics&#44; clinical variables and bleeding characteristics&#44; as well as data on progress and outcomes during their stay in the ICU were gathered&#46; The ICH score was used to assess intracerebral haemorrhage&#44; as its components &#40;age&#44; admission Glasgow Coma Scale &#40;GCS&#41;&#44; location&#44; volume and extension to the brain&#39;s ventricular system&#41; enable easy stratification of patients on admission&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The different variables were taken from the medical records&#44; paper-based in the first period and computerised in the other two periods&#46; In addition&#44; the Glasgow Outcome Scale &#40;GOS&#41; was assessed at one year&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> For this purpose&#44; the patients&#39; progress was monitored at subsequent follow-up appointments&#46; In patients whose progress was unclear&#44; a telephone call was made to assess their condition&#46; Patients were classified according to the GOS as poor prognosis &#40;GOS 1&#8722;3&#41; and good prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Quantitative variables are expressed as median &#40;interquartile range &#91;IQR&#93;&#41; and categorical variables as number &#40;percentage&#41;&#46; The chi-squared test was used to compare categorical variables&#46; Analysis of variance was used to compare quantitative variables&#44; with post hoc analysis using the Bonferroni test&#46; A p-value &#60;0&#46;05 was considered significant&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Authorisation was obtained from our hospital&#39;s Independent Ethics Committee&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">Overall&#44; in our unit&#44; of all patients with multiple trauma and neurocritical injuries over these 23 years&#44; 14&#46;4&#37; were admitted for SICH&#46; This represents 300 admissions&#44; distributed as follows&#58; period I&#44; 86 patients &#40;28&#46;7&#37;&#41;&#59; period II&#44; 109 patients &#40;36&#46;3&#37;&#41;&#59; and period III 105 patients &#40;35&#37;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Over the course of the 23 years&#44; 56&#46;7&#37; were male&#44; with a mean age of 66 years &#40;55&#46;5&#8211;74&#41;&#46; Of all the SICH cases&#44; 42&#46;2&#37; were located in the cerebral lobes&#44; 35&#46;3&#37; in the basal ganglia&#44; 15&#46;2&#37; cerebellar&#44; 4&#46;2&#37; in the brainstem and 3&#46;1&#37; in other locations&#46; There was intraventricular extension in 55&#37;&#44; with 21&#46;3&#37; of patients having placement of an external ventricular drain &#40;EVD&#41;&#46; In 60&#46;9&#37; the cause was hypertension&#44; followed by 17&#46;7&#37; in whom it was attributed to taking antiplatelet or anticoagulant drugs&#46; Surgical evacuation was performed in 38&#46;5&#37;&#46; The ICH score was 2 &#40;1&#8722;3&#41;&#46; Mechanical ventilation was applied in 71&#46;8&#37;&#44; with tracheostomy required in 22&#46;7&#37;&#46; Overall ICU stay was 5 &#40;2&#8211;14&#41; days&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The overall ICU mortality rate was 36&#46;8&#37;&#46; Assessed at one year&#44; the GOS scores were as follows&#58; 1 &#40;death&#41; 51&#46;3&#37;&#59; 2 &#40;persistent vegetative state&#41; 1&#46;5&#37;&#59; 3 &#40;severe disability&#41; 14&#46;5&#37;&#59; 4 &#40;moderate disability&#41; 17&#46;8&#37;&#59; and 5 &#40;minimal disability&#41; 14&#46;9&#37;&#46; The GOS was of poor prognosis in 67&#46;3&#37; and of good prognosis in 32&#46;7&#37;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The results in relation to baseline variables&#44; previous medical history and data characteristic of intracranial haemorrhage in the different periods studied are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; GCS on admission&#44; data on ICU progress and outcomes and the assessment of the GOS scale at one year after the episode are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; also for the three periods&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows changes in mortality rates over the three periods for the entire group and for basal ganglia and lobar haemorrhages&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the use of evacuation surgery in the three periods in the total number of patients and according to the type of haemorrhage&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the components of GOS at the one-year assessment in all patients and according to the site of the haemorrhage&#46; It should be noted that lobar and brainstem haemorrhages do not have group 2&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">The last twenty or thirty years have seen major advances in neurocritical patient care&#44; accompanied by better initial treatment&#44; better monitoring and more targeted treatment&#44; with the process focused on a better pathophysiological understanding of the factors involved&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;9</span></a> This has led to a better specialisation and&#44; over this time at our hospital&#44; our department has evolved from a Multipurpose Intensive Care Medicine Department in period I to a Department of Intensive Care Medicine with a Unit specialising in neurocritical patients &#40;periods II and III&#41;&#46; This complexity has led to a large percentage of patients referred from other centres&#44; with the aim of improving the complexity of management and decision-making&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">SICH patients account for 10&#8211;15&#37; of ACVA&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> We found the figures to be in this range in our series&#44; highlighting the significance of this disorder&#46; However&#44; intracranial haemorrhage is not a homogeneous entity&#44; but is determined by the characteristics of the haemorrhage&#46; Although there was no difference in the age of the patients in the periods we studied&#44; we did find a clear trend towards progressively more female SICH patients&#46; Attention has recently been drawn to the under-representation of women in clinical trials on SICH&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Over the three periods&#44; the prevalence of diabetes&#44; obesity&#44; previous SICH disease and anticoagulated patients progressively increased&#46; This was associated with worse prognosis&#44; with particular emphasis on the use of anticoagulants&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a> Interesting is the tendency to treat patients who have already had a previous SICH and who have recently been associated with a higher incidence of major cardiovascular events during admission&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Analysing the data related to the haemorrhages&#44; progressively more cerebellar &#40;probably due to the clearer surgical indication&#41; and brainstem haemorrhages have been referred to our Unit&#44; although the patient numbers are very small&#46; In contrast&#44; we have received fewer patients with basal ganglia haemorrhage&#46; The ICH score has increased significantly&#44; indicating greater extent and severity of bleeding&#46; Although early treatment has been associated with a trend towards better survival after controlling for severity &#40;ICH score&#41;&#44; it is clear that it is the most severe patients who tend to be referred&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This is in line with studies showing that patients who are not comatose or who do not need invasive mechanical ventilation in the first 24&#160;h can be monitored and treated outside the ICU or in non-specialised ICUs&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In relation to the ICU data&#44; we found a significant decrease in the use of invasive mechanical ventilation&#44; tracheostomy and length of stay in the different periods&#46; Although we are unable to draw firm conclusions from this&#44; the progressive improvement in the management of such patients in referral centres and in mechanical ventilation has been shown to impact on patient care&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Surgical indications have been one of the cornerstones of treatment&#46; In our series&#44; we found a very significant decrease in the number of patients requiring surgery&#46; This decreasing role of surgery&#44; as can be seen in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#44; is in line with the findings of the last 20 years&#46; Trials of the size of the Surgical Trial in Intracerebral Haemorrhage &#40;STICH I&#41;&#44; Surgical Trial in Lobar Intracerebral Haemorrhage &#40;STICH II&#41;&#44; Minimally Invasive Surgery plus rt-PA for Intracerebral Haemorrhage Evacuation &#40;MISTIE&#41; or Clot Lysis&#58; Evaluating Accelerated Resolution of Intraventricular Haemorrhage Phase III &#40;CLEAR III&#41; have not demonstrated statistically significant mid- and long-term functional improvement&#44; although the tendency is to believe that they reduce the fatality of neurological outcome<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a>&#59; this suggests that the ideal surgical management is yet to be determined&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;23</span></a> Not surprisingly&#44; at a theoretical level&#44; drainage of the haematoma has many benefits&#44; making it possible to reduce the mass effect and consequent brain herniation&#44; with the secondary damage caused by excitotoxicity and neurotoxicity of the blood products&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Despite a lack of certainty about the benefits of neurosurgery&#44; there is sufficient evidence to support certain surgical interventions&#44; such as the placement of external ventricular drains&#44; both for monitoring and for control of hydrocephalus related to bleeding into the ventricles&#59; 51&#37;&#8211;58&#37; of patients in our series had intraventricular haemorrhage&#44; which in itself is an independent factor of poor prognosis&#46; Ventricular catheter implantation also allows the instillation of fibrinolytics to facilitate clot dissolution&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">With regard to craniotomies&#44; given the lack of significant results in the aforementioned studies &#40;STICH I or II&#41;&#44; we noted a decrease in indications&#44; based on a clear differentiation between supra- and infratentorial SICH&#46; In infratentorial SICH&#44; external ventricular drain &#40;EVD&#41; placement combined with posterior fossa craniotomy and evacuation has been shown to be effective therapy&#44; especially in cerebellar haemorrhages larger than 3&#160;cm in size&#44; with early surgery indicated&#46; In supratentorial SICH&#44; we tend to individualise cases with regard to the indication for surgical evacuation&#44; with age&#44; comorbidities&#44; non-dominance&#44; mass effect and distance from the cortex being factors taken into account before operating&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11</span></a><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows that surgery at all sites has fallen &#40;almost half&#41;&#44; with the cerebellar sites showing the smallest decrease&#44; as the above-mentioned factors such as hydrocephalus are taken into consideration&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The role of decompressive craniectomy associated with evacuation is minimal&#44; linked to cases of poor prognosis and poor clinical status &#40;GCS&#160;&#8804;&#160;8&#41;&#46; Although this intervention can safely prevent intracranial hypertension not controllable with pharmacological measures&#44; with good clinical outcomes&#44; it is frequently associated with complications related to the surgical wound and outcomes can be frustrated by the severity of the patients selected&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> One issue pending at our hospital is to address the minimally invasive techniques that are starting to gain ground in large neurosurgical centres worldwide&#44; with the use of endoscopic or neuronavigation techniques&#44; such as the Stereotactic ICH Underwater Blood Aspiration &#40;SCUBA&#41; system&#44; which aim to minimise the morbidity associated with surgery&#44; with satisfactory evacuation rates&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The progressive implementation of less invasive techniques may open up new avenues of exploration&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The mortality rates improved only slightly&#44; but not significantly&#44; from Period I to II&#44; with one third of patients continuing to die in the ICU&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Although this is within the range reported in the literature&#44; many authors draw attention to the fact that the early mortality rate has remained unchanged at 30&#8211;40&#37; for more than 20 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a> It is striking that the one-year mortality rate is 51&#46;3&#37;&#44; indicating the seriousness of the disorder&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">This devastating disorder not only has an impact in terms of patient deaths&#44; but also in terms of functional status in survivors leading to significant changes in quality of life&#46; The use of rehabilitation teams helps to improve not only functional prognosis&#44; but also post-discharge mortality rates&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Assessed at one year&#44; 32&#46;7&#37; of our patients showed adequate functional recovery to enable them to lead a reasonably independent life &#40;GOS 4&#8722;5&#41;&#44; which is in line with the published range of 30&#8211;40&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows that cerebellar haemorrhages achieve a GOS score of 4&#8722;5 in 38&#46;1&#37; of patients at one year post-event&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Our study has several limitations&#44; not only in the retrospective review of cases&#44; but setting the study periods in an arbitrary way could certainly influence the results&#44; although we have tried to look at trends rather than absolute cut-off points&#46; Moreover&#44; the periods are not homogeneous&#44; as the first period covered three years and the others two years&#44; but we wanted to increase the size of comparison of the number of patients between the periods&#46; In addition&#44; there are variables with relevant prognostic factors that we could have considered&#44; such as evaluation of the haemorrhage volume in each location&#44; midline shift or the state of the basal cisterns&#44; and even establishing different analyses according to the various distinct aetiologies &#40;for example&#44; coagulopathy&#44; vascular&#41;&#46; However&#44; our aim was to provide an overview of a disorder that has continued to be important over the years&#44; without entering into considerations that would need to be made on an individual basis&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In <span class="elsevierStyleItalic">conclusion</span>&#44; severe SICH requires a complex approach and management in specialised units&#46; Over the last twenty or so years&#44; some presenting features in the ICU have changed&#44; with a higher prevalence in women and a greater likelihood of cardiovascular factors&#59; although the aetiology has not changed&#44; the severity has increased and&#44; in terms of location&#44; we have seen an increase in cerebellar and brainstem haemorrhage&#46; While the degree of severity has been greater&#44; length of ICU stay and the use of invasive mechanical ventilation and tracheostomy have decreased&#46; The use of open surgery has decreased by 50&#37;&#46; The mortality rate remains high&#44; stalling at 35&#37; in the ICU&#44; and the degree of disability at the one-year assessment is high&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0135" class="elsevierStylePara elsevierViewall">Our work received no funding from public&#44; private&#44; research or foundation bodies or any other source&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">To analyze the change in the characteristics of presentation&#44; evolution and treatment in the ICU&#44; as well as the functional evolution at 12 months of spontaneous intracranial hemorrhages &#40;ICHs&#41; treated in an ICU reference center&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patient and methods</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Descriptive&#44; retrospective study in a Neurocritical Reference Hospital&#46; All admissions of patients with HICE during three periods are studied&#58; 1999&#8211;2001 &#40;I&#41;&#44; 2015&#8211;2016 &#40;II&#41; and 2020&#8211;2021 &#40;III&#41;&#46; Evolution in the three periods of demographic variables&#44; baseline characteristics of the patients&#44; clinical variables and characteristics of bleeding&#44; evolutionary data in the ICU are studied&#46; At one year we assessed the GOS scale &#40;Glasgow Outcome Score&#41; according to whether they had a poor &#40;GOS 1&#8722;3&#41; or good &#40;GOS 4&#8722;5&#41; prognosis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">300 admitted patients&#44; distributed in periods&#58; I&#58; 28&#46;7&#37;&#44; II&#58; 36&#46;3&#37; and III&#58; 35&#37;&#46; 56&#46;7&#37; were males aged 66 &#40;55&#46;5&#8211;74&#41; years&#59; ICH score 2 &#40;1&#8722;3&#41;&#46; The ICU stay was 5 &#40;2&#8211;14&#41; days with a mortality of 36&#46;8&#37;&#46; GOS 1&#8722;3 a year in 67&#46;3&#37; and GOS 4&#8722;5 in 32&#46;7&#37;&#46; Comparing the three periods&#44; we observed a higher prevalence in women&#44; and the presence of cardiovascular factors&#59; no changes in etiology&#59; in relation to the location&#44; it increases cerebellar hemorrhage and in the brainstem&#46; Although the severity was greater&#44; the stay in the ICU&#44; the use of invasive mechanical ventilation and tracheostomy were lower&#46; Open surgery has decreased its use by 50&#37;&#46; Mortality continues to be high&#44; stagnating in the ICU at 35&#37; and entails a high degree of disability one year after assessment&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Severe ICH is a complex pathology that has changed some characteristics in the last two decades&#44; with more severe patients&#44; with more cardiovascular history and a greater predominance of brainstem and cerebellar hemorrhage&#46; Despite the increase in severity&#44; better parameters during the ICU stay&#44; with open surgery used 50&#37; less&#46; Mortality remains stagnant at 35&#37; with high disability per year&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Analizar el cambio de las caracter&#237;sticas de presentaci&#243;n&#44; evoluci&#243;n y tratamiento en UCI&#44; as&#237; como la evoluci&#243;n funcional a los 12 meses de las hemorragias intracraneal espont&#225;neas &#40;HICEs&#41; atendidas en una UCI centro de referencia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todo</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo&#44; retrospectivo en Hospital de Referencia neurocr&#237;ticos&#46; Se estudian todos los ingresos de pacientes con HICE durante tres periodos&#58; 1999&#8211;2001 &#40;I&#41;&#44; 2015&#8211;2016 &#40;II&#41; y 2020&#8211;2021 &#40;III&#41;&#46; Se estudian evoluci&#243;n en los tres periodos de variables demogr&#225;ficas&#44; caracter&#237;sticas basales de los pacientes&#44; variables cl&#237;nicas y caracter&#237;sticas de la hemorragia&#44; datos evolutivos en UCI&#46; Al a&#241;o valoramos la escala GOS &#40;Glasgow Outcome Score&#41; seg&#250;n presentaban mal &#40;GOS 1&#8722;3&#41; o buen pron&#243;stico &#40;GOS 4&#8722;5&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">300 pacientes ingresados&#44; distribuidos en periodos&#58; I&#58; 28&#44;7&#37;&#44; II&#58; 36&#44;3&#37; y III&#58; 35&#37;&#46; 56&#44;7&#37; eran varones con una edad 66 &#40;55&#44;5&#8211;74&#41; a&#241;os&#59; ICH score 2 &#40;1&#8722;3&#41;&#46; La estancia UCI fue de 5 &#40;2&#8211;14&#41; d&#237;as con una mortalidad del 36&#44;8&#37;&#46; Al a&#241;o GOS 1&#8722;3 en el 67&#44;3&#37; y GOS 4&#8722;5 en el 32&#44;7&#37;&#46; Comparando los tres periodos observamos mayor prevalencia en mujeres&#44; y presencia de factores cardiovasculares&#59; no cambios en la etiolog&#237;a&#59; en relaci&#243;n a la localizaci&#243;n&#44; aumenta la hemorragia cerebelosa y en troncoencefalo&#46; Aunque la gravedad fue mayor&#44; la estancia en UCI&#44; la utilizaci&#243;n de ventilaci&#243;n mec&#225;nica invasiva y la traqueostom&#237;a son menores&#46; La cirug&#237;a abierta ha disminuido su utilizaci&#243;n en un 50&#37;&#46; La mortalidad sigue siendo alta&#44; estancada en UCI en el 35&#37; y conlleva un alto grado de discapacidad al a&#241;o de valoraci&#243;n&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La HICE grave es una patolog&#237;a compleja que ha modificado algunas caracter&#237;sticas en las dos &#250;ltimas d&#233;cadas&#44; con pacientes m&#225;s graves&#44; con m&#225;s antecedentes cardiovasculares y mayor predominancia de la hemorragia en tronco-enc&#233;falo y cerebelosa&#46; A pesar de aumento gravedad&#44; mejores par&#225;metros en la estancia en UCI&#44; con una cirug&#237;a abierta que se utiliza un 50&#37; menos&#46; La mortalidad sigue estancada en un 35&#37; con una alta discapacidad al a&#241;o&#46;</p></span>"
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          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">ICH&#58; intracerebral haemorrhage&#59; SICH&#58; spontaneous intracranial haemorrhage&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Qualitative variables are expressed as number &#40;percentage&#41; and quantitative variables as median &#40;interquartile range&#41;&#46;</p>"
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period I &#40;N&#160;&#61;&#160;86&#59; 28&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period II &#40;N&#160;&#61;&#160;109&#59; 36&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period III &#40;N&#160;&#61;&#160;105&#59; 35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">65&#46;5 &#40;54&#8722;73&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;5 &#40;57&#8722;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;56&#8722;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">54 &#40;62&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;61&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;47&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;061&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Origin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Accident and Emergency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;47&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;72&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51 &#40;48&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ward&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;52&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;23&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;43&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous medical history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;61&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;66&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;61&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;725&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;12&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;24&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyslipidaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;30&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;34&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;9&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;14&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;18&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;29&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;15&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;039&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SICH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;190&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stroke&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Baseline medication&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antiplatelet therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;23&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;949&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anticoagulation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;15&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;15&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;413&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Haemorrhage data&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Aetiology&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertensive&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">62 &#40;72&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;55&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anticoagulants&#47;anti-platelet drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">20 &#40;21&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;15&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vascular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;2&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;13&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;9&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;12&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;16&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Site&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Basal ganglia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42 &#40;42&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lobar&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40 &#40;46&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">46 &#40;46&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;34&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">7 &#40;2&#8722;18&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;1&#46;5&#8722;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">62 &#40;62&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;74&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;018&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;22&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">20 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23 &#40;21&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;925&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Evacuation surgery&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23 &#40;23&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tracheostomy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;24&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;19&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;521&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ICU outcomes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ward&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60 &#40;60&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">65 &#40;61&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35 &#40;35&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;35&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other hospitals&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;2&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Reason for death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MODS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;7&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;16&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LTE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;28&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;30&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;29&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Brain death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;51&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;37&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Refractory ICHT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;11&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;10&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;5&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;10&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;5&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;371&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1-year outcome data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>GOS 1&#8722;3&nbsp;\t\t\t\t\t\t\n
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Clinical Research
Evaluation of the last 2 decades in the characteristics of presentation, management and prognosis of serious spontaneous intracerebral hemorrhage in a third level hospital
Evaluación de las últimas 2 décadas en las características de presentación, manejo y pronóstico de las hemorragias cerebrales espontáneas graves en un hospital de tercer nivel
Francisco Javier Morán Gallegoa, Marcelino Sanchez Casadoa,
Autor para correspondencia
mmsc16@gmail.com

Corresponding author.
, Ismael López de Toro Martin Consuegraa, Luis Marina Martineza, Javier Alvarez Fernandezb, María José Sánchez Carreteroa
a Servicio Medicina Intensiva, Hospital Universitario de Toledo, Spain
b Servicio Neurocirugía, Hospital Universitario de Toledo, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Spontaneous intracerebral haemorrhage &#40;SICH&#41; is a prevalent disease&#46; It is the second leading cause of acute cerebrovascular accident &#40;ACVA&#41;&#44; accounting for about 10&#8211;15&#37; of the total&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> The significance of SICH lies in its high rates of morbidity and mortality in a young adult population&#44; with mortality rates ranging from 30&#37; to 50&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In addition to neurological complications&#44; these patients often develop multiple systemic complications and&#44; as we also have to consider it a clinical process with different standardised phases of action&#44; specialised multidisciplinary management is required&#46; Management of SICH in the intensive care unit &#40;ICU&#41; and the involvement of the intensive medicine specialist and neurosurgeon in conjunction with other specialists constitute standard practice for this disorder&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> However&#44; the poor outcomes sometimes lead to a sense of futility about the measures applied&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Our <span class="elsevierStyleItalic">objective</span> was to analyse the changes over more than 20 years in the presenting features&#44; outcomes and treatment in the ICU&#44; and in functional prognosis at 12 months after SICH treated in the ICU of a referral hospital&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was a descriptive&#44; retrospective study in a tertiary level hospital&#44; a referral hospital for neurosurgical patients where only multiple trauma and neurocritical patients are treated&#46; Information was collected on all admissions of patients with SICH in three periods&#58; 1999&#8211;2001 &#40;period I&#41;&#59; 2015&#8211;2016 &#40;period II&#41;&#59; and 2020&#8211;2021 &#40;period III&#41;&#46; Demographic variables&#44; baseline patient characteristics&#44; clinical variables and bleeding characteristics&#44; as well as data on progress and outcomes during their stay in the ICU were gathered&#46; The ICH score was used to assess intracerebral haemorrhage&#44; as its components &#40;age&#44; admission Glasgow Coma Scale &#40;GCS&#41;&#44; location&#44; volume and extension to the brain&#39;s ventricular system&#41; enable easy stratification of patients on admission&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The different variables were taken from the medical records&#44; paper-based in the first period and computerised in the other two periods&#46; In addition&#44; the Glasgow Outcome Scale &#40;GOS&#41; was assessed at one year&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> For this purpose&#44; the patients&#39; progress was monitored at subsequent follow-up appointments&#46; In patients whose progress was unclear&#44; a telephone call was made to assess their condition&#46; Patients were classified according to the GOS as poor prognosis &#40;GOS 1&#8722;3&#41; and good prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Quantitative variables are expressed as median &#40;interquartile range &#91;IQR&#93;&#41; and categorical variables as number &#40;percentage&#41;&#46; The chi-squared test was used to compare categorical variables&#46; Analysis of variance was used to compare quantitative variables&#44; with post hoc analysis using the Bonferroni test&#46; A p-value &#60;0&#46;05 was considered significant&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Authorisation was obtained from our hospital&#39;s Independent Ethics Committee&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">Overall&#44; in our unit&#44; of all patients with multiple trauma and neurocritical injuries over these 23 years&#44; 14&#46;4&#37; were admitted for SICH&#46; This represents 300 admissions&#44; distributed as follows&#58; period I&#44; 86 patients &#40;28&#46;7&#37;&#41;&#59; period II&#44; 109 patients &#40;36&#46;3&#37;&#41;&#59; and period III 105 patients &#40;35&#37;&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Over the course of the 23 years&#44; 56&#46;7&#37; were male&#44; with a mean age of 66 years &#40;55&#46;5&#8211;74&#41;&#46; Of all the SICH cases&#44; 42&#46;2&#37; were located in the cerebral lobes&#44; 35&#46;3&#37; in the basal ganglia&#44; 15&#46;2&#37; cerebellar&#44; 4&#46;2&#37; in the brainstem and 3&#46;1&#37; in other locations&#46; There was intraventricular extension in 55&#37;&#44; with 21&#46;3&#37; of patients having placement of an external ventricular drain &#40;EVD&#41;&#46; In 60&#46;9&#37; the cause was hypertension&#44; followed by 17&#46;7&#37; in whom it was attributed to taking antiplatelet or anticoagulant drugs&#46; Surgical evacuation was performed in 38&#46;5&#37;&#46; The ICH score was 2 &#40;1&#8722;3&#41;&#46; Mechanical ventilation was applied in 71&#46;8&#37;&#44; with tracheostomy required in 22&#46;7&#37;&#46; Overall ICU stay was 5 &#40;2&#8211;14&#41; days&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The overall ICU mortality rate was 36&#46;8&#37;&#46; Assessed at one year&#44; the GOS scores were as follows&#58; 1 &#40;death&#41; 51&#46;3&#37;&#59; 2 &#40;persistent vegetative state&#41; 1&#46;5&#37;&#59; 3 &#40;severe disability&#41; 14&#46;5&#37;&#59; 4 &#40;moderate disability&#41; 17&#46;8&#37;&#59; and 5 &#40;minimal disability&#41; 14&#46;9&#37;&#46; The GOS was of poor prognosis in 67&#46;3&#37; and of good prognosis in 32&#46;7&#37;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The results in relation to baseline variables&#44; previous medical history and data characteristic of intracranial haemorrhage in the different periods studied are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; GCS on admission&#44; data on ICU progress and outcomes and the assessment of the GOS scale at one year after the episode are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; also for the three periods&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows changes in mortality rates over the three periods for the entire group and for basal ganglia and lobar haemorrhages&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the use of evacuation surgery in the three periods in the total number of patients and according to the type of haemorrhage&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a> shows the components of GOS at the one-year assessment in all patients and according to the site of the haemorrhage&#46; It should be noted that lobar and brainstem haemorrhages do not have group 2&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">The last twenty or thirty years have seen major advances in neurocritical patient care&#44; accompanied by better initial treatment&#44; better monitoring and more targeted treatment&#44; with the process focused on a better pathophysiological understanding of the factors involved&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;9</span></a> This has led to a better specialisation and&#44; over this time at our hospital&#44; our department has evolved from a Multipurpose Intensive Care Medicine Department in period I to a Department of Intensive Care Medicine with a Unit specialising in neurocritical patients &#40;periods II and III&#41;&#46; This complexity has led to a large percentage of patients referred from other centres&#44; with the aim of improving the complexity of management and decision-making&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">SICH patients account for 10&#8211;15&#37; of ACVA&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#8211;12</span></a> We found the figures to be in this range in our series&#44; highlighting the significance of this disorder&#46; However&#44; intracranial haemorrhage is not a homogeneous entity&#44; but is determined by the characteristics of the haemorrhage&#46; Although there was no difference in the age of the patients in the periods we studied&#44; we did find a clear trend towards progressively more female SICH patients&#46; Attention has recently been drawn to the under-representation of women in clinical trials on SICH&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Over the three periods&#44; the prevalence of diabetes&#44; obesity&#44; previous SICH disease and anticoagulated patients progressively increased&#46; This was associated with worse prognosis&#44; with particular emphasis on the use of anticoagulants&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a> Interesting is the tendency to treat patients who have already had a previous SICH and who have recently been associated with a higher incidence of major cardiovascular events during admission&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Analysing the data related to the haemorrhages&#44; progressively more cerebellar &#40;probably due to the clearer surgical indication&#41; and brainstem haemorrhages have been referred to our Unit&#44; although the patient numbers are very small&#46; In contrast&#44; we have received fewer patients with basal ganglia haemorrhage&#46; The ICH score has increased significantly&#44; indicating greater extent and severity of bleeding&#46; Although early treatment has been associated with a trend towards better survival after controlling for severity &#40;ICH score&#41;&#44; it is clear that it is the most severe patients who tend to be referred&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This is in line with studies showing that patients who are not comatose or who do not need invasive mechanical ventilation in the first 24&#160;h can be monitored and treated outside the ICU or in non-specialised ICUs&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;17</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In relation to the ICU data&#44; we found a significant decrease in the use of invasive mechanical ventilation&#44; tracheostomy and length of stay in the different periods&#46; Although we are unable to draw firm conclusions from this&#44; the progressive improvement in the management of such patients in referral centres and in mechanical ventilation has been shown to impact on patient care&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;19</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Surgical indications have been one of the cornerstones of treatment&#46; In our series&#44; we found a very significant decrease in the number of patients requiring surgery&#46; This decreasing role of surgery&#44; as can be seen in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#44; is in line with the findings of the last 20 years&#46; Trials of the size of the Surgical Trial in Intracerebral Haemorrhage &#40;STICH I&#41;&#44; Surgical Trial in Lobar Intracerebral Haemorrhage &#40;STICH II&#41;&#44; Minimally Invasive Surgery plus rt-PA for Intracerebral Haemorrhage Evacuation &#40;MISTIE&#41; or Clot Lysis&#58; Evaluating Accelerated Resolution of Intraventricular Haemorrhage Phase III &#40;CLEAR III&#41; have not demonstrated statistically significant mid- and long-term functional improvement&#44; although the tendency is to believe that they reduce the fatality of neurological outcome<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a>&#59; this suggests that the ideal surgical management is yet to be determined&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;23</span></a> Not surprisingly&#44; at a theoretical level&#44; drainage of the haematoma has many benefits&#44; making it possible to reduce the mass effect and consequent brain herniation&#44; with the secondary damage caused by excitotoxicity and neurotoxicity of the blood products&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Despite a lack of certainty about the benefits of neurosurgery&#44; there is sufficient evidence to support certain surgical interventions&#44; such as the placement of external ventricular drains&#44; both for monitoring and for control of hydrocephalus related to bleeding into the ventricles&#59; 51&#37;&#8211;58&#37; of patients in our series had intraventricular haemorrhage&#44; which in itself is an independent factor of poor prognosis&#46; Ventricular catheter implantation also allows the instillation of fibrinolytics to facilitate clot dissolution&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">With regard to craniotomies&#44; given the lack of significant results in the aforementioned studies &#40;STICH I or II&#41;&#44; we noted a decrease in indications&#44; based on a clear differentiation between supra- and infratentorial SICH&#46; In infratentorial SICH&#44; external ventricular drain &#40;EVD&#41; placement combined with posterior fossa craniotomy and evacuation has been shown to be effective therapy&#44; especially in cerebellar haemorrhages larger than 3&#160;cm in size&#44; with early surgery indicated&#46; In supratentorial SICH&#44; we tend to individualise cases with regard to the indication for surgical evacuation&#44; with age&#44; comorbidities&#44; non-dominance&#44; mass effect and distance from the cortex being factors taken into account before operating&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11</span></a><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows that surgery at all sites has fallen &#40;almost half&#41;&#44; with the cerebellar sites showing the smallest decrease&#44; as the above-mentioned factors such as hydrocephalus are taken into consideration&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The role of decompressive craniectomy associated with evacuation is minimal&#44; linked to cases of poor prognosis and poor clinical status &#40;GCS&#160;&#8804;&#160;8&#41;&#46; Although this intervention can safely prevent intracranial hypertension not controllable with pharmacological measures&#44; with good clinical outcomes&#44; it is frequently associated with complications related to the surgical wound and outcomes can be frustrated by the severity of the patients selected&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> One issue pending at our hospital is to address the minimally invasive techniques that are starting to gain ground in large neurosurgical centres worldwide&#44; with the use of endoscopic or neuronavigation techniques&#44; such as the Stereotactic ICH Underwater Blood Aspiration &#40;SCUBA&#41; system&#44; which aim to minimise the morbidity associated with surgery&#44; with satisfactory evacuation rates&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The progressive implementation of less invasive techniques may open up new avenues of exploration&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The mortality rates improved only slightly&#44; but not significantly&#44; from Period I to II&#44; with one third of patients continuing to die in the ICU&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> Although this is within the range reported in the literature&#44; many authors draw attention to the fact that the early mortality rate has remained unchanged at 30&#8211;40&#37; for more than 20 years&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">27&#44;28</span></a> It is striking that the one-year mortality rate is 51&#46;3&#37;&#44; indicating the seriousness of the disorder&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">This devastating disorder not only has an impact in terms of patient deaths&#44; but also in terms of functional status in survivors leading to significant changes in quality of life&#46; The use of rehabilitation teams helps to improve not only functional prognosis&#44; but also post-discharge mortality rates&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> Assessed at one year&#44; 32&#46;7&#37; of our patients showed adequate functional recovery to enable them to lead a reasonably independent life &#40;GOS 4&#8722;5&#41;&#44; which is in line with the published range of 30&#8211;40&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows that cerebellar haemorrhages achieve a GOS score of 4&#8722;5 in 38&#46;1&#37; of patients at one year post-event&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Our study has several limitations&#44; not only in the retrospective review of cases&#44; but setting the study periods in an arbitrary way could certainly influence the results&#44; although we have tried to look at trends rather than absolute cut-off points&#46; Moreover&#44; the periods are not homogeneous&#44; as the first period covered three years and the others two years&#44; but we wanted to increase the size of comparison of the number of patients between the periods&#46; In addition&#44; there are variables with relevant prognostic factors that we could have considered&#44; such as evaluation of the haemorrhage volume in each location&#44; midline shift or the state of the basal cisterns&#44; and even establishing different analyses according to the various distinct aetiologies &#40;for example&#44; coagulopathy&#44; vascular&#41;&#46; However&#44; our aim was to provide an overview of a disorder that has continued to be important over the years&#44; without entering into considerations that would need to be made on an individual basis&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">In <span class="elsevierStyleItalic">conclusion</span>&#44; severe SICH requires a complex approach and management in specialised units&#46; Over the last twenty or so years&#44; some presenting features in the ICU have changed&#44; with a higher prevalence in women and a greater likelihood of cardiovascular factors&#59; although the aetiology has not changed&#44; the severity has increased and&#44; in terms of location&#44; we have seen an increase in cerebellar and brainstem haemorrhage&#46; While the degree of severity has been greater&#44; length of ICU stay and the use of invasive mechanical ventilation and tracheostomy have decreased&#46; The use of open surgery has decreased by 50&#37;&#46; The mortality rate remains high&#44; stalling at 35&#37; in the ICU&#44; and the degree of disability at the one-year assessment is high&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Funding</span><p id="par0135" class="elsevierStylePara elsevierViewall">Our work received no funding from public&#44; private&#44; research or foundation bodies or any other source&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicts of interest</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">To analyze the change in the characteristics of presentation&#44; evolution and treatment in the ICU&#44; as well as the functional evolution at 12 months of spontaneous intracranial hemorrhages &#40;ICHs&#41; treated in an ICU reference center&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patient and methods</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Descriptive&#44; retrospective study in a Neurocritical Reference Hospital&#46; All admissions of patients with HICE during three periods are studied&#58; 1999&#8211;2001 &#40;I&#41;&#44; 2015&#8211;2016 &#40;II&#41; and 2020&#8211;2021 &#40;III&#41;&#46; Evolution in the three periods of demographic variables&#44; baseline characteristics of the patients&#44; clinical variables and characteristics of bleeding&#44; evolutionary data in the ICU are studied&#46; At one year we assessed the GOS scale &#40;Glasgow Outcome Score&#41; according to whether they had a poor &#40;GOS 1&#8722;3&#41; or good &#40;GOS 4&#8722;5&#41; prognosis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">300 admitted patients&#44; distributed in periods&#58; I&#58; 28&#46;7&#37;&#44; II&#58; 36&#46;3&#37; and III&#58; 35&#37;&#46; 56&#46;7&#37; were males aged 66 &#40;55&#46;5&#8211;74&#41; years&#59; ICH score 2 &#40;1&#8722;3&#41;&#46; The ICU stay was 5 &#40;2&#8211;14&#41; days with a mortality of 36&#46;8&#37;&#46; GOS 1&#8722;3 a year in 67&#46;3&#37; and GOS 4&#8722;5 in 32&#46;7&#37;&#46; Comparing the three periods&#44; we observed a higher prevalence in women&#44; and the presence of cardiovascular factors&#59; no changes in etiology&#59; in relation to the location&#44; it increases cerebellar hemorrhage and in the brainstem&#46; Although the severity was greater&#44; the stay in the ICU&#44; the use of invasive mechanical ventilation and tracheostomy were lower&#46; Open surgery has decreased its use by 50&#37;&#46; Mortality continues to be high&#44; stagnating in the ICU at 35&#37; and entails a high degree of disability one year after assessment&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Severe ICH is a complex pathology that has changed some characteristics in the last two decades&#44; with more severe patients&#44; with more cardiovascular history and a greater predominance of brainstem and cerebellar hemorrhage&#46; Despite the increase in severity&#44; better parameters during the ICU stay&#44; with open surgery used 50&#37; less&#46; Mortality remains stagnant at 35&#37; with high disability per year&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Analizar el cambio de las caracter&#237;sticas de presentaci&#243;n&#44; evoluci&#243;n y tratamiento en UCI&#44; as&#237; como la evoluci&#243;n funcional a los 12 meses de las hemorragias intracraneal espont&#225;neas &#40;HICEs&#41; atendidas en una UCI centro de referencia&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todo</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo&#44; retrospectivo en Hospital de Referencia neurocr&#237;ticos&#46; Se estudian todos los ingresos de pacientes con HICE durante tres periodos&#58; 1999&#8211;2001 &#40;I&#41;&#44; 2015&#8211;2016 &#40;II&#41; y 2020&#8211;2021 &#40;III&#41;&#46; Se estudian evoluci&#243;n en los tres periodos de variables demogr&#225;ficas&#44; caracter&#237;sticas basales de los pacientes&#44; variables cl&#237;nicas y caracter&#237;sticas de la hemorragia&#44; datos evolutivos en UCI&#46; Al a&#241;o valoramos la escala GOS &#40;Glasgow Outcome Score&#41; seg&#250;n presentaban mal &#40;GOS 1&#8722;3&#41; o buen pron&#243;stico &#40;GOS 4&#8722;5&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">300 pacientes ingresados&#44; distribuidos en periodos&#58; I&#58; 28&#44;7&#37;&#44; II&#58; 36&#44;3&#37; y III&#58; 35&#37;&#46; 56&#44;7&#37; eran varones con una edad 66 &#40;55&#44;5&#8211;74&#41; a&#241;os&#59; ICH score 2 &#40;1&#8722;3&#41;&#46; La estancia UCI fue de 5 &#40;2&#8211;14&#41; d&#237;as con una mortalidad del 36&#44;8&#37;&#46; Al a&#241;o GOS 1&#8722;3 en el 67&#44;3&#37; y GOS 4&#8722;5 en el 32&#44;7&#37;&#46; Comparando los tres periodos observamos mayor prevalencia en mujeres&#44; y presencia de factores cardiovasculares&#59; no cambios en la etiolog&#237;a&#59; en relaci&#243;n a la localizaci&#243;n&#44; aumenta la hemorragia cerebelosa y en troncoencefalo&#46; Aunque la gravedad fue mayor&#44; la estancia en UCI&#44; la utilizaci&#243;n de ventilaci&#243;n mec&#225;nica invasiva y la traqueostom&#237;a son menores&#46; La cirug&#237;a abierta ha disminuido su utilizaci&#243;n en un 50&#37;&#46; La mortalidad sigue siendo alta&#44; estancada en UCI en el 35&#37; y conlleva un alto grado de discapacidad al a&#241;o de valoraci&#243;n&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">La HICE grave es una patolog&#237;a compleja que ha modificado algunas caracter&#237;sticas en las dos &#250;ltimas d&#233;cadas&#44; con pacientes m&#225;s graves&#44; con m&#225;s antecedentes cardiovasculares y mayor predominancia de la hemorragia en tronco-enc&#233;falo y cerebelosa&#46; A pesar de aumento gravedad&#44; mejores par&#225;metros en la estancia en UCI&#44; con una cirug&#237;a abierta que se utiliza un 50&#37; menos&#46; La mortalidad sigue estancada en un 35&#37; con una alta discapacidad al a&#241;o&#46;</p></span>"
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Period III &#40;N&#160;&#61;&#160;105&#59; 35&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#46;5 &#40;54&#8722;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#46;5 &#40;57&#8722;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;56&#8722;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;786&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;62&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;61&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;47&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;061&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Origin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Accident and Emergency&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;47&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;72&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51 &#40;48&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ward&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;7&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45 &#40;52&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;23&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;43&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Previous medical history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 &#40;61&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;66&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;61&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;725&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;12&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;24&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;010&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyslipidaemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;30&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;34&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;9&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;14&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;281&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;18&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;29&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;15&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;039&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SICH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;3&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;7&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;190&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Stroke&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;20&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13 &#40;12&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Baseline medication&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antiplatelet therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;949&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anticoagulation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;15&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;15&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;413&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Haemorrhage data&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Aetiology&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hypertensive&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Anticoagulants&#47;anti-platelet drugs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vascular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;2&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;10&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;9&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;12&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;003&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Site&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Basal ganglia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42 &#40;42&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lobar&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">40 &#40;46&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">46 &#40;46&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">36 &#40;34&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cerebellar&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16 &#40;18&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;7&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Brainstem&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">3 &#40;3&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;2&#8722;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;1&#46;5&#8722;11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Invasive mechanical ventilation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">62 &#40;62&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78 &#40;74&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>External ventricular drainage&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;22&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20 &#40;20&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">23 &#40;21&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;925&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Evacuation surgery&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">56 &#40;65&#46;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">23 &#40;23&#46;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">33 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tracheostomy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">ICU outcomes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other hospitals&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Reason for death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LTE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Brain death&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Refractory ICHT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Other&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;5&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;10&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;371&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">1-year outcome data&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>GOS 1&#8722;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">47 &#40;58&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">67 &#40;72&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">71 &#40;68&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>GOS 4&#8722;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;41&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;27&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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