AI Article Synopsis
- Minimally invasive endoscopic evacuation for intracerebral hemorrhage (ICH) shows promise for improving patient outcomes, but it often leads to extended hospital stays, impacting costs.
- In a study with 226 patients, key factors contributing to longer hospital stays included higher initial functional impairment, concurrent intraventricular hemorrhage, and deeper hematoma locations.
- Prolonged hospital and ICU stays were linked to poorer discharge outcomes and decreased chances of recovery, suggesting that reducing LOS could enhance overall patient prognosis.
Article Abstract
Background: Minimally invasive evacuation may help ameliorate outcomes after intracerebral hemorrhage (ICH). However, hospital length of stay (LOS) post-evacuation is often long and costly.
Objective: To examine factors associated with LOS in a large cohort of patients who underwent minimally invasive endoscopic evacuation.
Methods: Patients presenting to a large health system with spontaneous supratentorial ICH qualified for minimally invasive endoscopic evacuation if they met the following inclusion criteria: age ≥18, premorbid modified Rankin Scale (mRS) score ≤3, hematoma volume ≥15 mL, and presenting National Institutes of Health Stroke Scale (NIHSS) score ≥6. Demographic, clinical, radiographic, and operative characteristics were included in a multivariate logistic regression for hospital and ICU LOS dichotomized into short and prolonged stay at 14 and 7 days, respectively.
Results: Among 226 patients who underwent minimally invasive endoscopic evacuation, the median intensive care unit and hospital LOS were 8 (4-15) days and 16 (9-27) days, respectively. A greater extent of functional impairment on presentation (OR per NIHSS point 1.10 (95% CI 1.04 to 1.17), P=0.007), concurrent intraventricular hemorrhage (OR=2.46 (1.25 to 4.86), P=0.02), and deep origin (OR=per point 2.42 (1.21 to 4.83), P=0.01) were associated with prolonged hospital LOS. A longer delay from ictus to evacuation (OR per hour 1.02 (1.01 to 1.04), P=0.007) and longer procedure time (OR per hour 1.91 (1.26 to 2.89), P=0.002) were associated with prolonged ICU LOS. Prolonged hospital and ICU LOS were in turn longitudinally associated with a lower rate of discharge to acute rehabilitation (40% vs 70%, P<0.0001) and worse 6-month mRS outcomes (5 (4-6) vs 3 (2-4), P<0.0001).
Conclusions: We present factors associated with prolonged LOS, which in turn was associated with poor long-term outcomes. Factors associated with LOS may help to inform patient and clinician expectations of recovery, guide protocols for clinical trials, and select suitable populations for minimally invasive endoscopic evacuation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/jnis-2023-020152 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Fracture Resistance and Wear Behavior of Ultra-Thin Occlusal Veneers Made From Translucent Zirconia Ceramics Bonded to Different Tooth Substrates.
J Esthet Restor Dent
January 2025
Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany.
Objective: Investigation of the mechanical properties of occlusal veneers made from zirconia with varying translucency, bonded to different tooth substrates.
Materials And Methods: Sixty-four extracted molars were divided into two groups: preparation within enamel (E) or extending into dentin (D). Veneers were milled from four zirconia ceramics (n = 8): 5Y-TZP (HT), a multilayer of 5 and 3Y-TZP (GT), 3Y-TZP (LT), and 4Y-TZP (MT).
Detection of neurologic changes in critically ill infants using deep learning on video data: a retrospective single center cohort study.
EClinicalMedicine
December 2024
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Infant alertness and neurologic changes can reflect life-threatening pathology but are assessed by physical exam, which can be intermittent and subjective. Reliable, continuous methods are needed. We hypothesized that our computer vision method to track movement, pose artificial intelligence (AI), could predict neurologic changes in the neonatal intensive care unit (NICU).
View Article and Find Full Text PDFTwo-Stage Total Laparoscopic Liver Resection at a Tertiary Center in Saudi Arabia: A Report of Two Cases.
Cureus
January 2025
Department of Surgery, King Saud University, College of Medicine, Riyadh, SAU.
Laparoscopic liver resection (LLR) is a minimally invasive surgical approach. Initially utilized for low-risk procedures, such as the resection of benign lesions, now LLR has evolved to include more complex operations such as metastatic lesions. We present in this article two cases with liver metastasis who underwent a successful two-stage total LLR: a 57-year-old man diagnosed with sigmoid cancer and liver metastasis and a 36-year-old man diagnosed with pancreatic neuroendocrine tumor and liver metastasis.
View Article and Find Full Text PDFReview of Outcomes of Intramedullary Fibular Nails in the Management of Ankle Fractures in Adults.
Cureus
December 2024
Trauma and Orthopaedics, Northwick Park Hospital, London, GBR.
Distal fibula fractures involving the ankle are one of the most common fractures, often requiring open reduction and internal fixation with plates and screws. The increased incidence of potential wound complications arising from open reduction methods led to a rejuvenated interest in the application of minimally invasive methods like intramedullary nailing of the fibula in the management of ankle fractures and isolated distal fibular fractures. A literature search was performed using Medline, Cochrane, and Embase from 1993 to 2023.
View Article and Find Full Text PDFMultiple burr hole and erythropoietin combination therapy: optimal early surgical intervention for patients with acute stroke episode of moyamoya disease or moyamoya syndrome.
Front Neurol
December 2024
Department of Neurosurgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea.
Objective: The optimal timing of bypass surgery for patients with moyamoya disease (MMD) or moyamoya syndrome (MMS) following an acute stroke episode remains unclear, mainly owing to the risk of postoperative complications. In this study, we aim to validate the safety and efficacy of early intervention using multiple burr hole (MBH) and erythropoietin (EPO) therapy, thereby refining the management strategy for patients with acute stroke episode of MMD or MMS.
Methods: We retrospectively analyzed data from 70 patients with MMD or MMS who underwent MBH and EPO therapy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!