Prognostic factors of clinical outcome after neuronavigation-assisted hematoma drainage in patients with spontaneous intracerebral hemorrhage

• Published in: Clinical neurology and neurosurgery 2014-08, Vol.123, p.83-89
• Main Authors: Kwon, Woo-Keun, Park, Dong-Hyuk, Park, Kyung-Jae, Kang, Shin-Hyuk, Lee, Jeong-Hyun, Cho, Tai-Hyoung, Chung, Yong-Gu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - diagnosis; Cerebral Hemorrhage - surgery; Clinical outcomes; Coma; Confidence intervals; Drainage - methods; Female; Glasgow Outcome Scale; Hematoma - complications; Hematoma - diagnosis; Hematoma - surgery; Hematoma drainage; Hemorrhage; Humans; Intracerebral hemorrhage; Male; Medical prognosis; Middle Aged; Multivariate analysis; Neurology; Neuronavigation; Neurosurgery; Prognostic factors; Studies; Treatment Outcome
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2014.05.016

Abstract Objective The prognostic factors that contribute to outcome after navigation-assisted drainage in patients with spontaneous intracerebral hemorrhage (ICH) have not been defined. We compared the characteristics and clinical outcomes of patients with spontaneous ICHs who underwent neuronavigation-assisted hematoma drainage. Methods Forty-seven patients were enrolled from January 2004 to August 2013. The patients were divided into two groups according to Glasgow Outcome Scale (GOS) scores: the good- (GOS 4–5) and poor-outcome (GOS 1–3) groups. A variety of factors, characteristics, and clinical outcomes were analyzed. Results Among the 47 patients, 16 and 31 showed good and poor outcomes, respectively. The mortality rate was 4.3%. Patients’ ages, horizontal and vertical diameters and volume of the hematoma on the initial brain computed tomography scan, and the initial Glasgow Coma Scale (GCS) scores were significantly different between the two groups ( P < 0.05). Ages less than 60 years, smaller horizontal and vertical diameters of the hematoma, less initial hematoma volume, higher initial GCS scores, and the absence of intraventricular hemorrhages were significantly associated with good outcome ( P < 0.05). Among these factors, initial hematoma volume was a borderline prognostic factor (odds ratio [OR], 0.951; 95% confidence interval [CI], 0.904–1.001; P = 0.054), whereas initial GCS score was a significant prognostic factor (OR, 2.737; 95% CI, 1.371–5.465; P = 0.004), in the multivariate analysis. Conclusion Initial GCS score and hematoma volume were important prognostic factors of clinical outcome in patients with spontaneous ICHs who underwent navigation-assisted drainage. Such factors should be carefully considered before patients are treated with navigation-assisted hematoma drainage.