Clinical and radiographic factors involved in achieving a hematoma evacuation rate of more than 70% through minimally invasive catheter drainage for spontaneous intracerebral hemorrhage |
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Institution: | 1. Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, FL, United States;2. Department of Neurological Surgery, The University of Texas at Houston, Houston, TX, United States;3. Center for Clinical Research & Evidence Based Medicine, The University of Texas at Houston, Houston, TX, United States;1. Kırıkkale University, Faculty of Medicine, Radiology Department, Kırıkkale, Turkey;2. Kırıkkale University, Faculty of Medicine, ENT Department, Kırıkkale, Turkey;3. Kırıkkale University, Faculty of Medicine, Neurology Department, Kırıkkale, Turkey;1. Umraniye Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey;2. Taksim Training and Research Hospital, Department of Neurosurgery, Istanbul, Turkey;3. Akdeniz University, School of Medicine, Antalya, Turkey;4. Istanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, Turkey;5. Acibadem Mehmet Ali Aydinlar University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey;1. Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India;2. Medical Physics, All India Institute of Medical Sciences, New Delhi, India |
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Abstract: | Although stereotactic or neuronavigation-guided hematoma drainage for spontaneous intracerebral hemorrhage (ICH) is widely used, its clinical efficacy and factors for predictive results remain to be fully elucidated. This study sought to determine the efficacy of hematoma evacuation for spontaneous ICH, in addition to the factors affecting it. We retrospectively reviewed patients who underwent stereotactic or neuronavigation-guided catheter insertion for spontaneous ICH at our institute between April 2010 and December 2019. We identified and compared the clinical and radiographic factors between groups according to the hematoma evacuation rate of 70%. Logistic regression analyses were performed to identify factors affecting hematoma evacuation. We investigated whether the hematoma evacuation rate was associated with patient survival. A total of 95 patients who underwent stereotactic or neuronavigation-guided catheter insertion and hematoma drainage for spontaneous ICH were included. A multivariate analysis indicated that a hematoma volume of 30–60 cm3 (odds ratio OR] = 8.064, 95% confidence interval CI] = 2.285–28.468, P = 0.001), blend sign (OR = 6.790, 95% CI = 1.239–37.210, P = 0.027), diabetes (OR = 0.188, 95% CI = 0.041–0.870, P = 0.032), and leukocytosis (OR = 3.061, 95% CI = 1.094–8.563, P = 0.033) were significantly associated with a higher hematoma evacuation. The mean hematoma evacuation rate in patients with 1-month mortality was lower than that in survivors (P = 0.051). Our study revealed that a hematoma volume of 30–60 cm3, the presence of a blend sign and leukocytosis, and the absence of diabetes are independent predictors that affect more than 70% of hematoma evacuations. |
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Keywords: | Hematoma evacuation ICH catheter Intracerebral hemorrhage Intrahematomal catheter Minimally invasive Outcome |
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