Background: Surgical treatment demonstrated a reduction in mortality among patients suffering from severe spontaneous intracerebral hemorrhage (SSICH). However, which SSICH patients could benefit from surgical treatment was unclear. This study aimed to establish and validate a decision tree (DT) model to help determine which SSICH patients could benefit from surgical treatment.

Materials And Methods: SSICH patients from a prospective, multicenter cohort study were analyzed retrospectively. The primary outcome was the incidence of neurological poor outcome (modified Rankin scale as 4-6) on the 180th day posthemorrhage. Then, surgically-treated SSICH patients were set as the derivation cohort (from a referring hospital) and validation cohort (from multiple hospitals). A DT model to evaluate the risk of 180-day poor outcome was developed within the derivation cohort and validated within the validation cohort. The performance of clinicians in identifying patients with poor outcome before and after the help of the DT model was compared using the area under curve (AUC).

Results: One thousand two hundred sixty SSICH patients were included in this study (middle age as 56, and 984 male patients). Surgically-treated patients had a lower incidence of 180-day poor outcome compared to conservatively-treated patients (147/794 vs. 128/466, P <0.001). Based on 794 surgically-treated patients, multivariate logistic analysis revealed the ischemic cerebro-cardiovascular disease history, renal dysfunction, dual antiplatelet therapy, hematoma volume, and Glasgow coma score at admission as poor outcome factors. The DT model, incorporating these above factors, was highly predictive of 180-day poor outcome within the derivation cohort (AUC, 0.94) and validation cohort (AUC, 0.92). Within 794 surgically-treated patients, the DT improved junior clinicians' performance to identify patients at risk for poor outcomes (AUC from 0.81 to 0.89, P <0.001).

Conclusions: This study provided a DT model for predicting the poor outcome of SSICH patients postsurgically, which may serve as a useful tool assisting clinicians in treatment decision-making for SSICH.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10871581PMC
http://dx.doi.org/10.1097/JS9.0000000000000852DOI Listing

Publication Analysis

Top Keywords

ssich patients
20
poor outcome
16
patients
10
decision tree
8
tree model
8
model help
8
severe spontaneous
8
spontaneous intracerebral
8
intracerebral hemorrhage
8
surgical treatment
8

Similar Publications

Relationship between high levels of D-dimer and prognosis in patients with spontaneous supratentorial cerebral haemorrhage: A retrospective study and double validation.

J Stroke Cerebrovasc Dis

November 2024

Hengyang Key Laboratory of Hemorrhagic Cerebrovascular Disease, Department of Neurosurgery, the Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, China. Electronic address:

Objective: The aim of this study was to investigate the correlation between D-Dimer and unfavorable outcome after surgery for spontaneous supratentorial intracerebral hemorrhage(SSICH) METHODS: A total of 557 patients with spontaneous supratentorial intracerebral hemorrhage underwent surgical treatment, which included craniotomy evacuation of hematoma and puncture and drainage. Based on the modified Rankin Scale (mRS) bifurcation, the patients were divided into two subgroups: favorable outcome (mRS score 0-2) and unfavorable outcome (mRS score 3-5). D-dimer levels were measured within 24 h of admission, monitored until discharge, and grouped by quartiles (Q1-Q4).

View Article and Find Full Text PDF

Objective: To assess safety and efficacy of minimally invasive evacuation of Spontaneous Supratentorial Intracerebral Hemorrhage (SSICH) by means of tailored minicraniotomies and intraoperative ultrasound (iUS) assistance.

Methods: Retrospective analysis of 55 patients who underwent microsurgical evacuation of SSICH using minicraniotomy and iUS assistance, between January 2015 and January 2022. Surgical complications, mortality rate, recurrent bleeding, percentage of hematoma evacuation and reliability of iUS were collected and investigated.

View Article and Find Full Text PDF
Article Synopsis
  • Spontaneous supratentorial intracerebral hemorrhage is a severe type of stroke with high mortality rates, and there are currently no effective treatments to improve patient outcomes.
  • This trial will assess the effects of early minimally invasive endoscopic surgery compared to the best medical treatment, focusing on functional outcomes after 6 months.
  • Conducted in Switzerland, this multicenter study aims to fill the gap in large randomized trials, potentially establishing new treatment options for this life-threatening condition.
View Article and Find Full Text PDF

Objective: Recent reports have demonstrated that a wider pulse pressure upon admission is correlated with heightened in-hospital mortality following spontaneous supratentorial intracerebral hemorrhage (ssICH). However, the underlying mechanism remains ambiguous. We investigated whether a wider pulse pressure was associated with hematoma expansion (HE).

View Article and Find Full Text PDF

Background: Surgical treatment demonstrated a reduction in mortality among patients suffering from severe spontaneous intracerebral hemorrhage (SSICH). However, which SSICH patients could benefit from surgical treatment was unclear. This study aimed to establish and validate a decision tree (DT) model to help determine which SSICH patients could benefit from surgical treatment.

View Article and Find Full Text PDF

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!