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Prognostic data analysis of surgical treatments for intracerebral hemorrhage

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Abstract

Spontaneous intracerebral hemorrhage (ICH) is a commonly occurring disease in neurosurgery, yet its surgical treatment is controversial. This paper pertains to the study of the effects of different treatment regimens on the outcome of ICH population. Based on a globally shared third-party MIMIC-III database, the researchers firstly described the dissimilarities in survival probability, mortality, and neurological recovery among mainstream treatments for ICH; secondly, patient classification was determined by important clinical features; and outcome variations among treatment groups were compared. The 28-day, 90-day, and in-hospital mortality in the craniotomy group were significantly lower than minimally invasive surgery (MIS) and non-surgical group patients; and, the medium/long-term mortality in MIS group was significantly lower than the non-surgical group. The craniotomy group positively correlated with short-term GCS recovery compared with the MIS group; no difference existed between the non-surgical and MIS groups. The craniotomy group 90-day survival probability and short-term GCS recovery were superior to the other two treatments in the subgroups of first GCS 3–12; this tendency also presented in the MIS group over non-surgical group. For milder patients (first GCS > 12), the three treatment regimens had a minimal effect on patient survival, but the non-surgical group showed an advantage in short-term GCS recovery. Craniotomy patients have a lower mortality and a better short-term neurological recovery in an ICH population, especially in short-to-medium term mortality and short-term neurological recovery over MIS patients. In addition, surgical treatment is recommendable for patients with a GCS ≤ 12.

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Data availability

The dataset presented in the current study is available in the MIMIC III database. (https://physionet.org/content/mimiciii/1.4/).

Code availability

Not applicable.

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Author information

Authors and Affiliations

  1. Neurosurgery Department, Guangzhou Overseas Chinese Hospital, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China

    Yongjun Yi, Wenqiang Che, Jiancheng Liao & Xiangyu Wang

  2. Neurosurgery Department, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China

    Yongfu Cao

  3. Neurosurgery Department, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China

    Fanfan Chen

  4. Clinical Research Department, Guangzhou Overseas Chinese Hospital, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China

    Jun Lyu

Authors
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  5. Jiancheng Liao
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Contributions

All the authors contributed to the study conception and design. Material preparation and data collection were performed by Yongjun Yi, Wenqiang Che, and Jun Lyu. Data analysis was performed by Yongfu Cao and Fanfan Chen. Literature search was performed by Jiancheng Liao. The first draft of the manuscript was written by Yongjun Yi, and Xiangyu Wang critically revised the manuscript. All the authors commented on the previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xiangyu Wang or Jun Lyu.

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Ethics approval

This is an observational study. The Guangzhou Overseas Chinese Hospital Research Ethics Committee has confirmed that no ethical approval is required.

Consent to participate

The database was established with the approval of the Massachusetts Institute of Technology (Cambridge, MA) and Beth Israel Deaconess Medical Center (Boston, MA), and consent was obtained for the original data collection. Therefore, this manuscript abandons the need for informed consent.

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Not applicable.

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The authors declare no competing interests.

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Yi, Y., Che, W., Cao, Y. et al. Prognostic data analysis of surgical treatments for intracerebral hemorrhage. Neurosurg Rev 45, 2733–2744 (2022). https://doi.org/10.1007/s10143-022-01785-5

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  • DOI: https://doi.org/10.1007/s10143-022-01785-5

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