Outcome Comparison Between Surgically Treated Brain Arteriovenous Malformation Hemorrhage and Spontaneous Intracerebral Hemorrhage.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
07 2020
Historique:
received: 27 02 2020
revised: 21 04 2020
accepted: 22 04 2020
pubmed: 4 5 2020
medline: 24 10 2020
entrez: 4 5 2020
Statut: ppublish

Résumé

Case fatality and poor outcome rates are different between brain arteriovenous malformation-associated intracerebral hemorrhage (bAVM-ICH) and spontaneous intracerebral hemorrhage (SICH). These outcome rates, however, have never been compared in patients who need neurosurgical evacuation of the intracerebral hemorrhage (ICH). To compare the short- and long-term functional outcome between surgically treated patients with bAVM-ICH and SICH. We collected data from surgically treated ICH patients at the Department of Neurosurgery, University Hospital Zurich, from January 2015 to July 2018. We performed logistic regression analysis to compare the functional outcome between groups, adjusting for demographics, admission characteristics, and stroke risk factors. A total of 26 bAVM-ICH and 115 SICH patients were included in the final analysis. Patients with bAVM-ICH were younger and less likely to have hypertension without significant differences in ICH volume, hematoma location, intraventricular hemorrhage, and other stroke risk factors. A significantly better functional outcome rate was seen in bAVM-ICH patients at short- and long-term follow-up. These differences remained significant after adjusting for confounders. patients with a bAVM who need surgical evacuation of an ICH have a more favorable outcome than surgically treated patients with spontaneous ICH, even after correction for confounding factors, such as younger age and less premorbid hypertension.

Sections du résumé

BACKGROUND
Case fatality and poor outcome rates are different between brain arteriovenous malformation-associated intracerebral hemorrhage (bAVM-ICH) and spontaneous intracerebral hemorrhage (SICH). These outcome rates, however, have never been compared in patients who need neurosurgical evacuation of the intracerebral hemorrhage (ICH).
OBJECTIVE
To compare the short- and long-term functional outcome between surgically treated patients with bAVM-ICH and SICH.
METHODS
We collected data from surgically treated ICH patients at the Department of Neurosurgery, University Hospital Zurich, from January 2015 to July 2018. We performed logistic regression analysis to compare the functional outcome between groups, adjusting for demographics, admission characteristics, and stroke risk factors.
RESULTS
A total of 26 bAVM-ICH and 115 SICH patients were included in the final analysis. Patients with bAVM-ICH were younger and less likely to have hypertension without significant differences in ICH volume, hematoma location, intraventricular hemorrhage, and other stroke risk factors. A significantly better functional outcome rate was seen in bAVM-ICH patients at short- and long-term follow-up. These differences remained significant after adjusting for confounders.
CONCLUSIONS
patients with a bAVM who need surgical evacuation of an ICH have a more favorable outcome than surgically treated patients with spontaneous ICH, even after correction for confounding factors, such as younger age and less premorbid hypertension.

Identifiants

pubmed: 32360923
pii: S1878-8750(20)30879-2
doi: 10.1016/j.wneu.2020.04.170
pii:
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e807-e811

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Wenhua Sun (W)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

Menno R Germans (MR)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland. Electronic address: Menno.Germans@usz.ch.

Martina Sebök (M)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

Jorn Fierstra (J)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

Zsolt Kulcsar (Z)

Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland; Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Annika Keller (A)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

Luca Regli (L)

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland; Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

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