Predictors of Mortality in Patients with Surgically Treated Spontaneous Intracranial Hemorrhage

İsmail Kaya; İlker Deniz Cingöz; İnan Uzunoğlu; Ceren Kızmazoğlu; Hasan Emre Aydın; Nurullah Yüceer

doi:10.4274/tnd.2019.67365

İsmail Kaya¹, İlker Deniz Cingöz², İnan Uzunoğlu³, Ceren Kızmazoğlu⁴, Hasan Emre Aydın¹, Nurullah Yüceer³

¹Kutahya University of Health Sciences, Department of Neurosurgery, Kutahya, Turkey
²Alsancak State Hospital, Clinic of Neurosurgery, Izmir, Turkey
³Katip Celebi University, Ataturk Training and Research Hospital, Department of Neurosurgery, Izmir, Turkey
⁴Dokuz Eylul University Faculty of Medicine, Department of Neurosurgery, Izmir, Turkey

Keywords: Surgical treatment, spontaneous intracranial hematoma, mortality, prognosis

Abstract

Objective: To investigate mortality in patients undergoing surgical treatment for spontaneous intracranial hemorrhage (sICH) and to identify the predictive factors.

Materials and Methods: The medical records of 164 patients with sICH who underwent surgery at two institutions between 2010 and 2017 were retrospectively examined and analyzed.

Results: Among 164 patients who received surgical treatment, 83 (50.6%) were women and 81 (49.4%) were men. The mean patient age was 56±14.54 years. Of all patients, 109 (66.4%) had hypertension. Hematoma was intraparenchymal in 69 (42.1%) patients, thalamic in 33 (20.1%), intraventricular in 33 (20.1%), and cerebellar in 29 (17.7%) patients. The mortality rate among patients who underwent surgery within the first 8 h of hematoma occurrence was 55.4%; this rate was 73% among those who underwent surgery 8-24 h after diagnosis, and 72.7% among those who underwent surgery 24-48 h after diagnosis.

Conclusion: Prognosis and mortality associated with sICH are usually affected by patient age, hematoma location and volume, intraventricular hemorrhage, and patient’s initial neurologic status. We found no significant relationship between surgical treatment 8 h after hemorrhage and mortality. There are still discussions about the indications of surgical treatment in intracranial hematomas.