Risk factors for unfavorable outcome after spontaneous intracerebral hemorrhage in elderly patients.

elderly patients intraventricular hemorrhage spontaneous intracerebral hemorrhage volumetry

Journal

Clinical neurology and neurosurgery
ISSN: 1872-6968
Titre abrégé: Clin Neurol Neurosurg
Pays: Netherlands
ID NLM: 7502039

Informations de publication

Date de publication:
22 Mar 2024
Historique:
received: 09 01 2024
revised: 15 02 2024
accepted: 20 03 2024
medline: 25 3 2024
pubmed: 25 3 2024
entrez: 24 3 2024
Statut: aheadofprint

Résumé

Spontaneous intracerebral hemorrhage (SICH) of the elderly is a devastating form of stroke with a high morbidity and economic burden. There is still a limited understanding of the risk factors for an unfavorable outcome where a surgical therapy may be less meaningful. Thus, the aim of this study is to identify factors associated with unfavorable outcome and time to death in surgically treated elderly patients with SICH. We performed a single-center retrospective study of 70 patients (age > 60 years) with SICH operated between 2008 and 2020. Functional outcome was assessed by modified Rankin Scale. Various clinical and neuroradiological variables including type of neurosurgical treatment, anatomical location of hemorrhage, volumetry and distribution of hemorrhage were assessed. Univariate and multivariate logistic regression models were performed. Length of stay (LOS) and hospital costs are presented. The overall mortality (mean follow-up time of 22 months) in this study was 32/70 patients (45.71%), 30-days mortality was 8/70 (11.42%), and 12-months mortality was 22/70 (31.43%). Average LOS was 73.5 days with a median of 58, 766 € estimated in hospital costs per patient. Multivariate analysis for 12-months mortality was significant for intraventricular hemorrhage (IVH) (p = 0.007, HR = 1.021, 95% CI = 1.006 - 1.037). ROC analysis for 12-months mortality for IVH volume >= 7 cm We identified IVH volume > 7 cm

Sections du résumé

BACKGROUND BACKGROUND
Spontaneous intracerebral hemorrhage (SICH) of the elderly is a devastating form of stroke with a high morbidity and economic burden. There is still a limited understanding of the risk factors for an unfavorable outcome where a surgical therapy may be less meaningful. Thus, the aim of this study is to identify factors associated with unfavorable outcome and time to death in surgically treated elderly patients with SICH.
METHODS METHODS
We performed a single-center retrospective study of 70 patients (age > 60 years) with SICH operated between 2008 and 2020. Functional outcome was assessed by modified Rankin Scale. Various clinical and neuroradiological variables including type of neurosurgical treatment, anatomical location of hemorrhage, volumetry and distribution of hemorrhage were assessed. Univariate and multivariate logistic regression models were performed. Length of stay (LOS) and hospital costs are presented.
RESULTS RESULTS
The overall mortality (mean follow-up time of 22 months) in this study was 32/70 patients (45.71%), 30-days mortality was 8/70 (11.42%), and 12-months mortality was 22/70 (31.43%). Average LOS was 73.5 days with a median of 58, 766 € estimated in hospital costs per patient. Multivariate analysis for 12-months mortality was significant for intraventricular hemorrhage (IVH) (p = 0.007, HR = 1.021, 95% CI = 1.006 - 1.037). ROC analysis for 12-months mortality for IVH volume >= 7 cm
CONCLUSIONS CONCLUSIONS
We identified IVH volume > 7 cm

Identifiants

pubmed: 38522225
pii: S0303-8467(24)00140-9
doi: 10.1016/j.clineuro.2024.108253
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

108253

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Author Declaration We hereby confirm, that the manuscript complies with all instructions to authors. We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

Auteurs

Vitalij Zeiser (V)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Farjad Khalaveh (F)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Anna Cho (A)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Andrea Reinprecht (A)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Johannes Herta (J)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Karl Rössler (K)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria.

Christian Dorfer (C)

Department of Neurosurgery, Medical University of Vienna, Waehringer Guertel 18-20, Vienna 1090, Austria. Electronic address: christian.dorfer@meduniwien.ac.at.

Classifications MeSH