14-Day Mortality Predictive Factors in Surgically Treated Supratentorial Spontaneous Intracerebral Hemorrhage: A Retrospective Analysis of 44 Patients

Abstract

Background: Spontaneous intracerebral hemorrhage accounts for 10-15% of cerebrovascular events. Various modalities of patient management, both conservatively and surgical. Despite its deadly nature and extensive studies, there is no standard model for predictive factors in intracerebral hemorrhage-related mortality. Methods: A retrospective cohort analysis on patients with supratentorial spontaneous intracerebral hemorrhage who received surgical treatment for clot evacuation. Factors including age, sex, initial Glasgow Coma Scale score, the volume of the clot, existing intraventricular hemorrhage, existing subarachnoid hemorrhage, signs of cerebral herniation from head CT-Scan, duration of the surgery, and surgical technique were analyzed. Results: Data for 44 patients were included in this study. The mean age was 54.68 ±12.79 years old, with 64.6% of the sample being males. The mean GCS score of the sample is 9.3 ± 3.15. Subarachnoid hemorrhage was noticed in 34.1% of cases. Intraventricular hemorrhage extension was found in 27.3% of cases. Cerebral herniation on CT-scan was noticed in 50% of cases. Based on surgical characteristics, the mean surgical time is 194.84 ± 54.84 mins. Almost two-thirds of the cases performed craniectomy procedure 28 (63.6%). We found that subarachnoid hemorrhage (OR 5.77 [1.12 – 29.7]; p = 0.036) and cerebral herniation (OR 8.26 [1.91- 35.7]; p = 0.005) were considered as significant factors in predicting 14-day mortality after multivariate analysis. Conclusions: Subarachnoid hemorrhage and cerebral herniation are good predictors of 14-day mortality in patients with sICH who are surgically treated. Earlier and shorter duration of the surgery showed no correlation to the outcome.