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Long-Term Functional Outcome and Quality of Life After Surgical Evacuation of Spontaneous Supratentorial Intracerebral Hemorrhage : Results from a Swedish Nationwide Cohort

Jakobsson, Johan ; Redebrandt, Henrietta Nittby LU ; Tobieson, Lovisa ; Bartek, Jiri LU ; Bartley, Andreas ; Troberg, Ebba LU ; Mirza, Sadia ; Tsitsopoulos, Parmenion P. ; Marklund, Niklas LU orcid and Fahlström, Andreas (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.

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organization
publishing date
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
2024-06-10 14:18:09
@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}},
}