Age as a prognostic factor in relation to surgical evacuation of spontaneous supratentorial intracerebral haemorrhage

Spontaneous intracerebral haemorrhage (sICH) is an acute life-threatening injury and constitutes 10–15% of first-ever stroke cases. The Surgical Trials in Intracerebral Haematoma studies (STICH and STICH II) represent the two foremost studies in the field, however, with arguable shortcomings. To find more accurate criteria, we aimed to correlate the preoperative neurological and neuroimaging findings with the clinical outcome of operated patients. In this retrospective study, sICH patients were recruited from the Central Denmark Region from 2010 to 2016. We evaluated the patients’ medical records regarding preoperative Glasgow Coma Scale (GCS) 6 months and one year after surgery, focal neurological defects, thrombolytic treatment, pupil status, and haemorrhage localization visualized by neuroimaging. The patients’ clinical outcome was assessed using the Glasgow Outcome Scale (GOS). Based on logistic multiple linear analysis, age, basal ganglia haemorrhage and mass effect had significant effect on the mortality rate. Besides, age, basal ganglia haemorrhage, intra ventricular haemorrhage and pupil difference had significant correlation with good outcome (GOS>3). Neurosurgical treatment of the sICH patients is indicated only if age and potentially improved morbidity is carefully evaluated considering the STICH and this study; otherwise, we will just increase the health care burden with a number of extremely care-dependent patients.