Surgery for Patients With Spontaneous Deep Supratentorial Intracerebral Hemorrhage
| Autor: | Sen Lin, Chao You, Meng Tian, Rui Guo, Hao Li, Jun Zheng, He-Xiang Zhao, Lu Ma, Yuan Fang, Wei Dong, Ming Liu |
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| Rok vydání: | 2016 |
| Předmět: |
Intracerebral hemorrhage
medicine.medical_specialty business.industry Incidence (epidemiology) Case-control study Retrospective cohort study General Medicine medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine Hematoma Intraventricular hemorrhage Anesthesia Propensity score matching medicine 030212 general & internal medicine Young adult business 030217 neurology & neurosurgery |
| Zdroj: | Medicine. 95:e3024 |
| ISSN: | 0025-7974 |
| DOI: | 10.1097/md.0000000000003024 |
| Popis: | Spontaneous intracerebral hemorrhage (sICH) is one of the most dangerous cerebrovascular diseases, especially when in deep brain. The treatment of spontaneous deep supratentorial intracerebral hemorrhage is still controversial. We conducted a retrospective case-control study using propensity score matching to compare the efficacy of surgery and conservative treatment for patients with deep surpatentorial hemorrhage. We observed the outcomes of consecutive patients with spontaneous deep supratentorial hemorrhage retrospectively from December 2008 to July 2013. Clinical outcomes of surgery and conservative treatments were compared in patients with deep sICH using propensity score matching method. The primary outcome was neurological function status at 6 months post ictus. The second outcomes included mortality at 30 days and 6 months, and the incidence of complications. Subgroup analyses of 6-month outcome were conducted. Sixty-three (22.66%) of the 278 patients who received surgery had a favorable neurological function status at 6 months, whereas in the conservative group, 66 of 278 (23.74%) had the same result (P = 0.763). The 30-day mortality in the surgical group was 19.06%, whereas 30.58% in the conservative group (P = 0.002). There was significant difference in the mortality at 6 months after ictus as well (23.38% vs 36.33%, P = 0.001). The subgroup analyses showed significantly better outcomes for the surgical group when hematoma was >40 mL (13.33% vs 0%, P = 0.005) or complicated with intraventricular hemorrhage (16.67% vs 7.27%, P = 0.034). For complications, the risk of pulmonary infection, gastrointestinal hemorrhage, urinary infection, pulmonary embolus, and need for tracheostomy/long term ventilation in the surgical group was higher than the conservative group (31.29% vs 15.47%, P |
| Databáze: | OpenAIRE |
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