The Cognitive Impairment At Acute Stage After Intracerebral Hemorrhage

Background: We determined the frequency and factors of cognitive impairment at acute stage and investigate the prognostic effect of the cognitive function at acute stage on the delayed cognitive impairment after acute intracerebral hemorrhage (ICH). Methods: A total of 208 patients with acute ICH were enrolled from January 2017 to February 2019. Cognitive function was assessed during the acute stage and follow-up after ICH using Montreal Cognitive Assessment (MoCA) score. The significant acute stage and delayed cognitive impairment was defined as a MoCA score <20 within 1 week after hospital admission and during follow-up respectively. Results: During a mean 20 (IQC 17-23) months follow-up, 185 patients with follow-up cognitive function data. There are 89 (42.8%) and 86 (46.5%) patients had acute stage and delayed significant cognitive impairment respectively. The older age, large baseline hematoma volume, more severe ICH, and low level of education were significant associated with significant cognitive impairment at acute stage (all P＜0.009). In the multivariable logistic regression model, the low acute phase MoCA score (odds ratio [OR] 0.59; 95% confidence interval [CI] 0.48-0.71; P＜0.001) was the only one independent factor associated with delayed significant cognitive impairment after ICH. Conclusions: Near half of patients have significant cognitive impairment at acute stage after ICH, which is more frequent in the elderly, those with large baseline hematoma volume, and more severe initial neurological deficit. The acute phase MoCA score was independent increased the risk of delayed cognitive impairment.