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Prediction of Long-Term Outcome After Intracerebral Hemorrhage Surgery

Troberg, Ebba LU ; Kronvall, Erik LU ; Hansen, Björn M. LU and Nilsson, Ola G. LU (2018) In World Neurosurgery
Abstract

Background: Surgery for spontaneous primary intracerebral hemorrhage (ICH) remains controversial. Previous surgical trials have primarily focused on short-term mortality while studies on long-term functional outcome are rare. We therefore conducted this retrospective study of long-term outcome on all ICH patients who underwent craniotomy at a single neurosurgical center during a 10-year period. Methods: We included all patients >15 years of age who underwent evacuation of spontaneous ICH at Skåne University Hospital between 2003 and 2012. Case fatality at 30 days, 1 year, and long-term follow-up (up to 10 years) were analyzed in relation to potential predictors of outcome. Long-term functional outcome was assessed in 2013 by... (More)

Background: Surgery for spontaneous primary intracerebral hemorrhage (ICH) remains controversial. Previous surgical trials have primarily focused on short-term mortality while studies on long-term functional outcome are rare. We therefore conducted this retrospective study of long-term outcome on all ICH patients who underwent craniotomy at a single neurosurgical center during a 10-year period. Methods: We included all patients >15 years of age who underwent evacuation of spontaneous ICH at Skåne University Hospital between 2003 and 2012. Case fatality at 30 days, 1 year, and long-term follow-up (up to 10 years) were analyzed in relation to potential predictors of outcome. Long-term functional outcome was assessed in 2013 by telephone interview using the modified Rankin Scale (mRS). Results: Of 229 operated patients, overall case fatality was 20% at 30 days and 31% at 1 year. For patients with supratentorial ICH, the case fatality was 16% at 30 days and 27% at 1 year, and 29% at 30 days and 41% at 1 year for patients with cerebellar ICH. The most consistent independent predictors of mortality were preictal heart disease and level of consciousness on admission. Of 185 patients with long-term functional outcome available (median follow-up 6.14 years), 44 of them (24%) had a good outcome (mRS score 0–3) and 141 (76%) were severely disabled or dead (mRS score 4–6). Conclusions: The case fatality in our study was comparatively low, but most survivors lived dependently several years after surgery. Heart disease and level of consciousness were the most consistent predictors of mortality.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Intracerebral hemorrhage, Long-term outcome, Prognosis, Risk factors, Surgery
in
World Neurosurgery
publisher
Elsevier
external identifiers
  • scopus:85060335159
ISSN
1878-8750
DOI
10.1016/j.wneu.2018.12.012
language
English
LU publication?
yes
id
22f1ef0e-2030-4093-9e02-0dacb2d64454
date added to LUP
2019-02-01 09:37:34
date last changed
2019-02-27 05:11:43
@article{22f1ef0e-2030-4093-9e02-0dacb2d64454,
  abstract     = {<p>Background: Surgery for spontaneous primary intracerebral hemorrhage (ICH) remains controversial. Previous surgical trials have primarily focused on short-term mortality while studies on long-term functional outcome are rare. We therefore conducted this retrospective study of long-term outcome on all ICH patients who underwent craniotomy at a single neurosurgical center during a 10-year period. Methods: We included all patients &gt;15 years of age who underwent evacuation of spontaneous ICH at Skåne University Hospital between 2003 and 2012. Case fatality at 30 days, 1 year, and long-term follow-up (up to 10 years) were analyzed in relation to potential predictors of outcome. Long-term functional outcome was assessed in 2013 by telephone interview using the modified Rankin Scale (mRS). Results: Of 229 operated patients, overall case fatality was 20% at 30 days and 31% at 1 year. For patients with supratentorial ICH, the case fatality was 16% at 30 days and 27% at 1 year, and 29% at 30 days and 41% at 1 year for patients with cerebellar ICH. The most consistent independent predictors of mortality were preictal heart disease and level of consciousness on admission. Of 185 patients with long-term functional outcome available (median follow-up 6.14 years), 44 of them (24%) had a good outcome (mRS score 0–3) and 141 (76%) were severely disabled or dead (mRS score 4–6). Conclusions: The case fatality in our study was comparatively low, but most survivors lived dependently several years after surgery. Heart disease and level of consciousness were the most consistent predictors of mortality.</p>},
  author       = {Troberg, Ebba and Kronvall, Erik and Hansen, Björn M. and Nilsson, Ola G.},
  issn         = {1878-8750},
  keyword      = {Intracerebral hemorrhage,Long-term outcome,Prognosis,Risk factors,Surgery},
  language     = {eng},
  month        = {12},
  publisher    = {Elsevier},
  series       = {World Neurosurgery},
  title        = {Prediction of Long-Term Outcome After Intracerebral Hemorrhage Surgery},
  url          = {http://dx.doi.org/10.1016/j.wneu.2018.12.012},
  year         = {2018},
}