Prognostic factors and long-term outcome following surgical treatment of 76 patients with spontaneous cerebellar haematoma
Tsitsopoulos, Parmenion P ; Tobieson, Lovisa ; Enblad, Per and Marklund, Niklas LU
(2012)
In Acta Neurochirurgica
154(7).
p.95-1189
- Abstract
BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.
METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.
RESULTS: Prior to... (More)
BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.
METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.
RESULTS: Prior to surgery, the median GCS score was 8.6 (range 3-13). At discharge it had improved to 12.1 (4-15) (p < 0.05). The median long-term follow-up period was 70.5 (22-124) months. At 6 months post-surgery, 19 patients were dead and 28 patients had a good outcome (mRS < 3). In the long term (70.5 months), 31 patients (41.9 %) were dead and the outcome was good in 27 patients (37.8 %). Although approximately 25 % of patients >65 years old had a favourable outcome, age was the strongest negative predictor for a bad outcome at 6 months and long term (p = 0.02 and p = 0.01, respectively). The level of consciousness before surgery did not influence the 6-month or long-term outcome (p = 0.39 and p = 0.65, respectively).
CONCLUSIONS: Although mortality was high, significant complications from the treatment were rare and most survivors had a good outcome, reaching functional independence. High age was the strongest prognostic factor for an unfavourable outcome.
(Less)
- author
- Tsitsopoulos, Parmenion P
; Tobieson, Lovisa
; Enblad, Per
and Marklund, Niklas
LU
- publishing date
- 2012-07
- type
- Contribution to journal
- publication status
- published
- keywords
- Adult, Age Factors, Aged, Cerebellar Diseases, Decompression, Surgical, Female, Follow-Up Studies, Glasgow Coma Scale, Hematoma, Humans, Male, Middle Aged, Postoperative Complications, Prognosis, Retrospective Studies, Survival Rate, Sweden
- in
- Acta Neurochirurgica
- volume
- 154
- issue
- 7
- pages
- 95 - 1189
- publisher
- Springer
- external identifiers
-
- pmid:22619023
- scopus:84865761087
- ISSN
- 0001-6268
- DOI
- 10.1007/s00701-012-1372-7
- language
- English
- LU publication?
- no
- id
- 1d6b2a5c-2707-498c-926b-7004aa370bf2
- date added to LUP
- 2018-03-04 11:47:53
- date last changed
- 2024-05-27 07:55:25
@article{1d6b2a5c-2707-498c-926b-7004aa370bf2,
abstract = {{<p>BACKGROUND: Although large spontaneous cerebellar haematomas are associated with high mortality, surgical treatment may be life-saving. We evaluated the clinical outcome and identified prognostic factors in 76 patients with cerebellar haematoma, all treated with suboccipital decompression, haematoma evacuation and external ventricular drainage.</p><p>METHODS: Patients receiving surgical and neurocritical care treatment within a 10-year period were included. Level of consciousness during hospitalisation was evaluated using the Glasgow Coma Scale (GCS) score. Outcome was assessed with the modified Rankin Scale (mRS). Predictive prognostic factors were analysed using univariate and multivariate regression analysis.</p><p>RESULTS: Prior to surgery, the median GCS score was 8.6 (range 3-13). At discharge it had improved to 12.1 (4-15) (p < 0.05). The median long-term follow-up period was 70.5 (22-124) months. At 6 months post-surgery, 19 patients were dead and 28 patients had a good outcome (mRS < 3). In the long term (70.5 months), 31 patients (41.9 %) were dead and the outcome was good in 27 patients (37.8 %). Although approximately 25 % of patients >65 years old had a favourable outcome, age was the strongest negative predictor for a bad outcome at 6 months and long term (p = 0.02 and p = 0.01, respectively). The level of consciousness before surgery did not influence the 6-month or long-term outcome (p = 0.39 and p = 0.65, respectively).</p><p>CONCLUSIONS: Although mortality was high, significant complications from the treatment were rare and most survivors had a good outcome, reaching functional independence. High age was the strongest prognostic factor for an unfavourable outcome.</p>}},
author = {{Tsitsopoulos, Parmenion P and Tobieson, Lovisa and Enblad, Per and Marklund, Niklas}},
issn = {{0001-6268}},
keywords = {{Adult; Age Factors; Aged; Cerebellar Diseases; Decompression, Surgical; Female; Follow-Up Studies; Glasgow Coma Scale; Hematoma; Humans; Male; Middle Aged; Postoperative Complications; Prognosis; Retrospective Studies; Survival Rate; Sweden}},
language = {{eng}},
number = {{7}},
pages = {{95--1189}},
publisher = {{Springer}},
series = {{Acta Neurochirurgica}},
title = {{Prognostic factors and long-term outcome following surgical treatment of 76 patients with spontaneous cerebellar haematoma}},
url = {{http://dx.doi.org/10.1007/s00701-012-1372-7}},
doi = {{10.1007/s00701-012-1372-7}},
volume = {{154}},
year = {{2012}},
}