Clinical outcome of the patients treated surgically for spontaneous intracerebral hematoma at Sawanpracharak Hospital
Lowprukmanee, N.
Journal of the Medical Association of Thailand 96(6): 669-677
2013
ISSN/ISBN: 0125-2208 PMID: 23951823 Document Number: 11500
To study the relationship of factors associated with clinical outcome in surgical groups of spontaneous intracerebral hematoma patients (SICH). The data were retrospectively collected from surgically treated SICH patients who had surgery at Sawanpracharak Hospital between October 2006 and September 2009. Risk factors (heart disease, previous stroke, hypertension, diabetes mellitus (DM), hyperlipidemia, obesity, smoking, alcoholic consumption, and family history), Glasgow Coma Scale (GCS), hematoma volume, midline shift (MS), intraventricular bleeding (IVH), hydrocephalus, convulsion, tracheostomy, pneumonia, rebleeding, operating time, and intraoperative blood loss were studied. Throughout the study period, 380 patients with SICH underwent surgical treatment. Factors that were statistically significant related to outcome of SICH were age (p < 0.001), diabetes mellitus (p < 0.001), smoking (p = 0.003), alcoholic consumption (p = 0.001), Glasgow Coma Scale (p < 0.001), hematoma volume (p < 0.001), midline shift (p < 0.001), intraventricular bleeding (p < 0.001), hydrocephalus (p < 0.001), pneumonia (p < 0.001), rebleeding (p = 0.006), operating time (p < 0.001), and intraoperative blood loss (p = 0.008). After logistic regression analysis was done, factors that were statistically significantly related were Glasgow Coma Scale 3 to 8 [OR 6.03 (3.09-11.75); p < 0.001], Glasgow Coma Scale 9 to 12 [OR 3.29 (1.87-5.77); p < 0.001], intraventricular bleeding [OR 2.33 (1.37-3.98); p = 0.002], pneumonia [OR 1.62 (1.00-4.23); p = 0.049], rebleeding [OR 2.30 (1.04-5.08); p = 0.040], operating time greater than two hours [OR 3.05 (1.11-8.34); p = 0.030], and midline shift greater than 10 mm [OR 2.07 (1.04-3.57); p = 0.038]. Outcome of surgical treatment of SICH in the present study were related to age, diabetes mellitus, smoking, alcoholic consumption, Glasgow Coma Scale 3 to 8 and 9 to 12, hematoma volume, midline shift greater than 10 mm, intraventricular bleeding, hydrocephalus, pneumonia, rebleeding, operating time greater than two hours, and intra operative blood loss.
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