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Open Access 14-08-2023 | Stroke Unit | Original Article

Medical versus neurosurgical treatment in ICH patients: a single center experience

Authors: P. Pierini, Agnese Novelli, F. Bossi, R. Corinaldesi, M. Paciaroni, M. G. Mosconi, A. Alberti, M. Venti, I. Leone de Magistris, V. Caso

Published in: Neurological Sciences | Issue 1/2024

Abstract

Background and aims

The effect of surgical treatment for spontaneous intracerebral hemorrhage (ICH) remains uncertain. We conducted an observational retrospective cohort study on supra-centimeter spontaneous ICH treated with either neurosurgical or conservative management. The baseline demographics and risk factors were correlated with in-hospital mortality and 3 and 6-month survival rates stratified by management.

Methods

We included all patients with evidence of spontaneous ICH > 1 cm detected by CT and admitted between august 2020 and march 2021 to the “SMM” Hospital in Perugia.

Results

Onehundredandtwentytwo patients were included in the study, and 45% (n.55) were surgically treated. The mean age was 71.9 ± 15.3, and 61% (n.75) were males. Intra-hospital mortality ended up being 31% (n.38), 3 months-survival was 63% (n.77) and 6 months-survival was 60% (n.73).

From the multivariate analysis of the surgical patients versus medical patient, we observed that the surgical patients were younger (67.5 ± 14.9 vs 75.5 ± 14.7 y; OR 0.87; Cl 95% 0.85–0.94; p 0.001), with greater ICH volume at the onset (61 ± 39.4 cc vs 51 ± 64 cc; OR 1.03; Cl 95% 1.005–1.07; p 0.05), more midline shift (7.61 ± 5.54 mm vs 4.09 ± 5.88 mm; OR 1.37; Cl 95% 1.045–1.79; p 0.023), and a higher ICH score (3 vs 2 mean ICH score; OR 21.12; Cl 95% 2.6–170.6; p 0.004). Intra-hospital mortality in the surgical group and in the conservative treatment group was respectively 33% vs 30%, 3 month-survival was 64% vs 63% and 6 month- survival were 60% in both groups.

Conclusions

Our patient cohort shows no overall benefit from surgery over conservative treatment, but surgical patients were younger and had larger ICH volume.

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Title: Medical versus neurosurgical treatment in ICH patients: a single center experience
Authors: P. Pierini
Agnese Novelli
F. Bossi
R. Corinaldesi
M. Paciaroni
M. G. Mosconi
A. Alberti
M. Venti
I. Leone de Magistris
V. Caso
Publication date: 14-08-2023
Publisher: Springer International Publishing
Keywords: Stroke Unit
Stroke
Published in: Neurological Sciences / Issue 1/2024
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-023-07015-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Medical versus neurosurgical treatment in ICH patients: a single center experience

Abstract

Background and aims

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and aims

Methods

Results

Conclusions

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