Long-Term Functional Outcome and Quality of Life After Surgical Evacuation of Spontaneous Supratentorial Intracerebral Hemorrhage : Results from a Swedish Nationwide Cohort
(2023) In World Neurosurgery 170. p.351-363- Abstract
Objective: To investigate long-term survival, neurologic outcome, and quality of life in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) treated with craniotomy and hematoma evacuation. Methods: A nationwide multicenter retrospective analysis of 341 patients who underwent craniotomy and evacuation of supratentorial ICH between January 1, 2011, and December 31, 2015, was performed. Baseline characteristics associated with 6-month mortality and long-term mortality were investigated. Survivors received a questionnaire about their state of health from which EuroQol 5D (EQ-5D) and modified Rankin scale (mRS) were obtained. Predictors of mortality, unfavorable outcome, and life quality were analyzed. Results: The mean... (More)
Objective: To investigate long-term survival, neurologic outcome, and quality of life in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) treated with craniotomy and hematoma evacuation. Methods: A nationwide multicenter retrospective analysis of 341 patients who underwent craniotomy and evacuation of supratentorial ICH between January 1, 2011, and December 31, 2015, was performed. Baseline characteristics associated with 6-month mortality and long-term mortality were investigated. Survivors received a questionnaire about their state of health from which EuroQol 5D (EQ-5D) and modified Rankin scale (mRS) were obtained. Predictors of mortality, unfavorable outcome, and life quality were analyzed. Results: The mean follow-up time was 55.2 months. Predictors of 6-month mortality in multiple regression analysis were age ≥75 years, previous myocardial infarction, lower level of consciousness, and mechanical ventilation. Predictors of long-term mortality were higher age and mechanical ventilation. At follow-up, 49.5% of survivors had a favorable neurologic outcome (mRS ≤3). Predictors of an unfavorable functional outcome were higher age and ICH volume ≥50 mL. The mean EQ-5D health index was 0.719, and the mean EQ-5D visual analog scale score was 53.9. In multiple regression, only a higher mRS score was significantly associated with worse life quality. Conclusions: Knowledge about survival, functional outcome, and life quality as well as their predictors in this specific patient group is previously primarily described in short-term follow-up. This multicenter study provides novel information in the long-term perspective, which is important for improved surgical decision-making and prognostication.
(Less)
- author
- Jakobsson, Johan ; Redebrandt, Henrietta Nittby LU ; Tobieson, Lovisa ; Bartek, Jiri LU ; Bartley, Andreas ; Troberg, Ebba LU ; Mirza, Sadia ; Tsitsopoulos, Parmenion P. ; Marklund, Niklas LU and Fahlström, Andreas
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Craniotomy, Intracerebral hemorrhage, Neurologic outcome, Quality of life
- in
- World Neurosurgery
- volume
- 170
- pages
- 351 - 363
- publisher
- Elsevier
- external identifiers
-
- scopus:85143141404
- pmid:36368454
- ISSN
- 1878-8750
- DOI
- 10.1016/j.wneu.2022.11.013
- language
- English
- LU publication?
- yes
- id
- ca7fa960-d86b-4037-ae97-8cdbf27317d1
- date added to LUP
- 2023-01-30 14:42:23
- date last changed
- 2024-09-16 20:03:11
@article{ca7fa960-d86b-4037-ae97-8cdbf27317d1, abstract = {{<p>Objective: To investigate long-term survival, neurologic outcome, and quality of life in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) treated with craniotomy and hematoma evacuation. Methods: A nationwide multicenter retrospective analysis of 341 patients who underwent craniotomy and evacuation of supratentorial ICH between January 1, 2011, and December 31, 2015, was performed. Baseline characteristics associated with 6-month mortality and long-term mortality were investigated. Survivors received a questionnaire about their state of health from which EuroQol 5D (EQ-5D) and modified Rankin scale (mRS) were obtained. Predictors of mortality, unfavorable outcome, and life quality were analyzed. Results: The mean follow-up time was 55.2 months. Predictors of 6-month mortality in multiple regression analysis were age ≥75 years, previous myocardial infarction, lower level of consciousness, and mechanical ventilation. Predictors of long-term mortality were higher age and mechanical ventilation. At follow-up, 49.5% of survivors had a favorable neurologic outcome (mRS ≤3). Predictors of an unfavorable functional outcome were higher age and ICH volume ≥50 mL. The mean EQ-5D health index was 0.719, and the mean EQ-5D visual analog scale score was 53.9. In multiple regression, only a higher mRS score was significantly associated with worse life quality. Conclusions: Knowledge about survival, functional outcome, and life quality as well as their predictors in this specific patient group is previously primarily described in short-term follow-up. This multicenter study provides novel information in the long-term perspective, which is important for improved surgical decision-making and prognostication.</p>}}, author = {{Jakobsson, Johan and Redebrandt, Henrietta Nittby and Tobieson, Lovisa and Bartek, Jiri and Bartley, Andreas and Troberg, Ebba and Mirza, Sadia and Tsitsopoulos, Parmenion P. and Marklund, Niklas and Fahlström, Andreas}}, issn = {{1878-8750}}, keywords = {{Craniotomy; Intracerebral hemorrhage; Neurologic outcome; Quality of life}}, language = {{eng}}, pages = {{351--363}}, publisher = {{Elsevier}}, series = {{World Neurosurgery}}, title = {{Long-Term Functional Outcome and Quality of Life After Surgical Evacuation of Spontaneous Supratentorial Intracerebral Hemorrhage : Results from a Swedish Nationwide Cohort}}, url = {{http://dx.doi.org/10.1016/j.wneu.2022.11.013}}, doi = {{10.1016/j.wneu.2022.11.013}}, volume = {{170}}, year = {{2023}}, }