Woo-Keun Kwon1, Dong-Hyuk Park2, Kyung-Jae Park1, Shin-Hyuk Kang1, Jeong-Hyun Lee3, Tai-Hyoung Cho4, Yong-Gu Chung1. 1. Department of Neurosurgery, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea. 2. Department of Neurosurgery, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea; Center of Innovative Cell Therapy and Research, Anam Hospital, Korea University College of Medicine, Seoul, South Korea. Electronic address: doctorns@korea.com. 3. Center of Innovative Cell Therapy and Research, Anam Hospital, Korea University College of Medicine, Seoul, South Korea; Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea. 4. Department of Neurosurgery, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea; Center of Innovative Cell Therapy and Research, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Abstract
OBJECTIVE: The prognostic factors that contribute to outcome after navigation-assisted drainage in patients with spontaneous intracerebral hemorrhage (ICH) have not been defined. We compared the characteristics and clinical outcomes of patients with spontaneous ICHs who underwent neuronavigation-assisted hematoma drainage. METHODS: Forty-seven patients were enrolled from January 2004 to August 2013. The patients were divided into two groups according to Glasgow Outcome Scale (GOS) scores: the good- (GOS 4-5) and poor-outcome (GOS 1-3) groups. A variety of factors, characteristics, and clinical outcomes were analyzed. RESULTS: Among the 47 patients, 16 and 31 showed good and poor outcomes, respectively. The mortality rate was 4.3%. Patients' ages, horizontal and vertical diameters and volume of the hematoma on the initial brain computed tomography scan, and the initial Glasgow Coma Scale (GCS) scores were significantly different between the two groups (P<0.05). Ages less than 60 years, smaller horizontal and vertical diameters of the hematoma, less initial hematoma volume, higher initial GCS scores, and the absence of intraventricular hemorrhages were significantly associated with good outcome (P<0.05). Among these factors, initial hematoma volume was a borderline prognostic factor (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.904-1.001; P=0.054), whereas initial GCS score was a significant prognostic factor (OR, 2.737; 95% CI, 1.371-5.465; P=0.004), in the multivariate analysis. CONCLUSION: Initial GCS score and hematoma volume were important prognostic factors of clinical outcome in patients with spontaneous ICHs who underwent navigation-assisted drainage. Such factors should be carefully considered before patients are treated with navigation-assisted hematoma drainage.
OBJECTIVE: The prognostic factors that contribute to outcome after navigation-assisted drainage in patients with spontaneous intracerebral hemorrhage (ICH) have not been defined. We compared the characteristics and clinical outcomes of patients with spontaneous ICHs who underwent neuronavigation-assisted hematoma drainage. METHODS: Forty-seven patients were enrolled from January 2004 to August 2013. The patients were divided into two groups according to Glasgow Outcome Scale (GOS) scores: the good- (GOS 4-5) and poor-outcome (GOS 1-3) groups. A variety of factors, characteristics, and clinical outcomes were analyzed. RESULTS: Among the 47 patients, 16 and 31 showed good and poor outcomes, respectively. The mortality rate was 4.3%. Patients' ages, horizontal and vertical diameters and volume of the hematoma on the initial brain computed tomography scan, and the initial Glasgow Coma Scale (GCS) scores were significantly different between the two groups (P<0.05). Ages less than 60 years, smaller horizontal and vertical diameters of the hematoma, less initial hematoma volume, higher initial GCS scores, and the absence of intraventricular hemorrhages were significantly associated with good outcome (P<0.05). Among these factors, initial hematoma volume was a borderline prognostic factor (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.904-1.001; P=0.054), whereas initial GCS score was a significant prognostic factor (OR, 2.737; 95% CI, 1.371-5.465; P=0.004), in the multivariate analysis. CONCLUSION: Initial GCS score and hematoma volume were important prognostic factors of clinical outcome in patients with spontaneous ICHs who underwent navigation-assisted drainage. Such factors should be carefully considered before patients are treated with navigation-assisted hematoma drainage.
Authors: Anirudh Sreekrishnan; Jennifer L Dearborn; David M Greer; Fu-Dong Shi; David Y Hwang; Audrey C Leasure; Sonya E Zhou; Emily J Gilmore; Charles C Matouk; Nils H Petersen; Lauren H Sansing; Kevin N Sheth Journal: Neurocrit Care Date: 2016-12 Impact factor: 3.210