Spontaneous Intracerebral Hematoma: A Single Center 10-Year Analysis

Veysel Kiyak
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Abstract

Objective: In this study, we aimed to contribute to the literature by determining data such as mortality rates, demographic, clinical and radiological characteristics of patients who applied to our hospital's emergency department between January 2011 and December 2020 with the diagnosis of SISH and were operated on in our clinic. Methods:53 patients who were operated on for SISH diagnosis between January 2011 and December 2020 were retrospectively examined. Patients with SISH on brain tomography (CT) were evaluated. Hematoma localization is lobar; those with frontal, parietal, temporal and occipital locations; Those in the thalamic, putaminal and basal ganglia were considered to be deeply located. Patients were divided into three groups according to the Glasgow coma score (GCS): GCS 5–8, GCS 9–12, and GCS 13–15. Results: In our cohort, the patients mean age was 62.8 years (range, 19–92). The overall mortality rate was 62.87%. Age showed no significant association with mortality. Mortality was associated with increased hematoma volume and low GCS score at the first presentation (p < 0.001). In receiver operating characteristic curve analysis, hematoma volume was an important predictor of surgical outcome; the optimal cut-off value of 59.5 cm3 was associated with 84.4% sensitivity and 90.5% specificity (p < 0.001). Similarly, the optimal GCS score cut-off value of 8.5 was associated with a 96.9% sensitivity and 71.4% specificity for predicting mortality (p < 0.001). Conclusions:Low GCS, increased hematoma volume, and especially the presence of concomitant hypertension (HT) are associated with poor prognosis in SISH patients.
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自发性脑内血肿:单中心 10 年分析
研究目的在这项研究中,我们旨在确定 2011 年 1 月至 2020 年 12 月期间因诊断为 SISH 而到我院急诊科就诊并在我院接受手术的患者的死亡率、人口学、临床和放射学特征等数据,从而为文献做出贡献。方法:回顾性研究2011年1月至2020年12月期间因诊断为SISH而接受手术的53例患者。对脑断层扫描(CT)显示为SISH的患者进行评估。血肿定位为脑叶;位于额叶、顶叶、颞叶和枕叶者为深部血肿;位于丘脑、普塔米尔和基底节者为深部血肿。根据格拉斯哥昏迷评分(GCS)将患者分为三组:GCS 5-8、GCS 9-12、GCS 13-15。结果患者平均年龄为 62.8 岁(19-92 岁)。总死亡率为 62.87%。年龄与死亡率无明显关系。死亡率与血肿体积增大和首次就诊时 GCS 评分较低有关(P < 0.001)。在接收器操作特征曲线分析中,血肿体积是预测手术结果的一个重要指标;59.5 立方厘米的最佳截断值具有 84.4% 的灵敏度和 90.5% 的特异性(p < 0.001)。同样,最佳 GCS 评分临界值为 8.5 时,预测死亡率的敏感性为 96.9%,特异性为 71.4%(p < 0.001)。结论:GCS评分低、血肿体积增大,尤其是合并高血压(HT)与SISH患者的不良预后有关。
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