Impact of Tobacco Use on 30-Day Mortality in Subjects Presenting with Spontaneous Intracerebral Hematoma: Retrospective Analysis of 335 Subjects

Introduction: Spontaneous intracerebral hematoma (ICH) causes significant morbidity and mortality. Risk factors for early mortality still need to be clearly elucidated. This study aimed to identify factors associated with 30-day mortality, hematoma volume, and the presence of intravascular hematoma in subjects presenting with spontaneous ICH.

Methods: All consecutive subjects (>18 years) admitted to the intensive care unit between January 2013 and June 2021 with spontaneous ICH were analyzed retrospectively. Detailed systemic and neurological examinations were recorded and evaluated from files.

Results: A total of 335 subjects (51.3% male, median age 68 [55–77] years) with ICH were included in the study. Of these, 230 were smokers (68.7%), 105 were nonsmokers (31.3%). Compared to nonsmokers, smokers had a lower Glasgow Coma Scale score (p=0.036), larger hematoma volume (p=0.034), higher frequency of intraventricular hematoma (p=0.013). Multiple logistic regression revealed that smokers had 2.069-fold higher risk of death than non-smokers (OR: 2.069, 95% CI: 1.115–3.839, p=0.021). Smoking was also independently associated with the presence of intraventricular hematoma (OR: 1.669, 95% CI: 1.027–2.711, p=0.039).

Discussion and Conclusion: The study showed that smokers have a 2.069-fold greater risk of 30-day mortality and a 1.669-fold higher likelihood of having intraventricular hematoma following spontaneous ICH than nonsmokers.

Keywords: Intracerebral hematoma; Intraventricular hematoma; Mortality; Smoking; Tobacco