Clinical Outcome of the Patients Treated Surgically
for Spontaneous Intracerebral Hematoma
at Sawanpracharak Hospital
Nrongpong Lowprukmanee MD*
Affiliation :
* Department of Surgery, Sawanpracharak Hospital, Nakhonsawan, Thailand
Objective : To study the relationship of factors associated with clinical outcome in surgical groups of spontaneous intracerebral
hematoma patients (SICH).
Material and Method: The data were retrospectively collected from surgically treated SICH patients who had surgery at
Sawanpracharak Hospital between October 2006 and September 2009. Risk factors ( heart disease, previous stroke,
hypertension, diabetes mellitus (DM), hyperlipidemia, obesity, smoking, alcoholic consumption, and family history), Glasgow
Coma Scale (GCS), hematoma volume, midline shift (MS), intraventricular bleeding (IVH), hydrocephalus, convulsion,
tracheostomy, pneumonia, rebleeding, operating time, and intraoperative blood loss were studied.
Results : Throughout the study period, 380 patients with SICH underwent surgical treatment. Factors that were statistically
significant related to outcome of SICH were age (p<0.001), diabetes mellitus (p<0.001), smoking (p = 0.003), alcoholic
consumption (p = 0.001), Glasgow Coma Scale (p<0.001), hematoma volume (p<0.001), midline shift (p<0.001),
intraventricular bleeding (p<0.001), hydrocephalus (p<0.001), pneumonia (p<0.001), rebleeding (p = 0.006), operating
time (p<0.001), and intraoperative blood loss (p = 0.008). After logistic regression analysis was done, factors that were
statistically significantly related were Glasgow Coma Scale 3 to 8 [OR 6.03 (3.09-11.75); p<0.001], Glasgow Coma Scale
9 to 12 [OR 3.29 (1.87-5.77); p<0.001], intraventricular bleeding [OR 2.33 (1.37-3.98); p = 0.002], pneumonia
[OR 1.62 (1.00-4.23); p = 0.049], rebleeding [OR 2.30 (1.04-5.08); p = 0.040], operating time greater than two hours
[OR 3.05 (1.11-8.34); p = 0.030], and midline shift greater than 10 mm [OR 2.07 (1.04-3.57); p = 0.038].
Conclusion : Outcome of surgical treatment of SICH in the present study were related to age, diabetes mellitus, smoking,
alcoholic consumption, Glasgow Coma Scale 3 to 8 and 9 to 12, hematoma volume, midline shift greater than 10 mm,
intraventricular bleeding, hydrocephalus, pneumonia, rebleeding, operating time greater than two hours, and intra operative
blood loss.
Keywords : Spontaneous intracerebral hematoma, Glasgow coma scale, Hematoma volume, Intraventricular bleeding,
Hydrocephalus, Glasgow outcome scale
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