Long-Term Follow-up in Patients with Spontaneous Intracerebral Hemorrhage Treated With or Without Surgical Intervention: a Large-Scale Retrospective Study
Debates regarding the most beneficial medical or surgical procedures for patients with spontaneous intracerebral hemorrhage (sICH) are still ongoing. We aimed to evaluate the risk of subsequent vascular disease and mortality in patients with sICH treated with and without surgical intervention, in a...
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| Veröffentlicht in: | Neurotherapeutics 2019-07, Vol.16 (3), p.891-900 |
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| creator | Chen, XianXiu Su, Yuan-Chih Chen, Chun-Chung Guo, Jeng-Hung Wu, Chih-ying Wei, Sung-Tai Chen, Der-Cherng Lin, Jung-Ju Shieh, Shwn-Huey Chiu, Cheng-Di |
| description | Debates regarding the most beneficial medical or surgical procedures for patients with spontaneous intracerebral hemorrhage (sICH) are still ongoing. We aimed to evaluate the risk of subsequent vascular disease and mortality in patients with sICH treated with and without surgical intervention, in a large-scale Asian population. Patients hospitalized within 2000 to 2013 who were newly diagnosed with sICH were identified using the National Health Insurance Research Database of Taiwan. Neuroendoscopy and craniotomy groups comprised patients who underwent surgical treatment within 1 week, while those in the control group did not undergo early surgical treatment. Outcomes included subsequent hemorrhagic and ischemic stroke, following acute myocardial infarction, congestive heart failure, and mortality. After propensity score matching, there were 663 patients in each group. Compared to that in the control group, the neuroendoscopy and craniotomy groups had a significantly higher risk of secondary vascular events at 1 to 3 months of follow-up (adjusted HR, 2.08 and 1.95; 95% CI, 1.21–3.58 and 1.13–3.35;
p
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| doi_str_mv | 10.1007/s13311-019-00722-7 |
| format | Article |
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p
< 0.01 and
p
< 0.05, respectively), but a significantly lower risk after 3 years of follow-up (adjusted HR, 0.52 and 0.52; 95% CI, 0.35–0.78 and 0.35–0.77;
p
< 0.01 and
p
< 0.01, respectively). The mortality rate was higher in the craniotomy group at 6 to 12 months of follow-up (adjusted HR, 2.18; 95% CI, 1.06–4.49;
p
< 0.05) compared to that in the control group. Thus, a timely surgical intervention for hematoma evacuation is advantageous in preventing secondary vascular events and improving outcomes in the long term. However, greater attention to secondary ischemic stroke following the initial sICH episode is needed.</description><identifier>ISSN: 1933-7213</identifier><identifier>ISSN: 1878-7479</identifier><identifier>EISSN: 1878-7479</identifier><identifier>DOI: 10.1007/s13311-019-00722-7</identifier><identifier>PMID: 30788666</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Aged ; Biomedical and Life Sciences ; Biomedicine ; Cerebral Hemorrhage - complications ; Cerebral Hemorrhage - mortality ; Cerebral Hemorrhage - surgery ; Cerebral Hemorrhage - therapy ; Cerebral infarction ; Congestive heart failure ; Craniotomy - adverse effects ; Craniotomy - methods ; Female ; Follow-Up Studies ; Hematoma ; Hemorrhage ; Humans ; Ischemia ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Neurobiology ; Neurology ; Neurosciences ; Neurosurgery ; Original ; Original Article ; Patients ; Propensity Score ; Retrospective Studies ; Risk Factors ; Stroke ; Taiwan ; Treatment Outcome ; Vascular diseases</subject><ispartof>Neurotherapeutics, 2019-07, Vol.16 (3), p.891-900</ispartof><rights>The American Society for Experimental NeuroTherapeutics, Inc. 2019</rights><rights>Neurotherapeutics is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-cd68a1ffb26fd7dce768486091367ca93fb497e0d00c0dc1168dd6cb291dab043</citedby><cites>FETCH-LOGICAL-c474t-cd68a1ffb26fd7dce768486091367ca93fb497e0d00c0dc1168dd6cb291dab043</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694356/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694356/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,41486,42555,51317,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30788666$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, XianXiu</creatorcontrib><creatorcontrib>Su, Yuan-Chih</creatorcontrib><creatorcontrib>Chen, Chun-Chung</creatorcontrib><creatorcontrib>Guo, Jeng-Hung</creatorcontrib><creatorcontrib>Wu, Chih-ying</creatorcontrib><creatorcontrib>Wei, Sung-Tai</creatorcontrib><creatorcontrib>Chen, Der-Cherng</creatorcontrib><creatorcontrib>Lin, Jung-Ju</creatorcontrib><creatorcontrib>Shieh, Shwn-Huey</creatorcontrib><creatorcontrib>Chiu, Cheng-Di</creatorcontrib><title>Long-Term Follow-up in Patients with Spontaneous Intracerebral Hemorrhage Treated With or Without Surgical Intervention: a Large-Scale Retrospective Study</title><title>Neurotherapeutics</title><addtitle>Neurotherapeutics</addtitle><addtitle>Neurotherapeutics</addtitle><description>Debates regarding the most beneficial medical or surgical procedures for patients with spontaneous intracerebral hemorrhage (sICH) are still ongoing. We aimed to evaluate the risk of subsequent vascular disease and mortality in patients with sICH treated with and without surgical intervention, in a large-scale Asian population. Patients hospitalized within 2000 to 2013 who were newly diagnosed with sICH were identified using the National Health Insurance Research Database of Taiwan. Neuroendoscopy and craniotomy groups comprised patients who underwent surgical treatment within 1 week, while those in the control group did not undergo early surgical treatment. Outcomes included subsequent hemorrhagic and ischemic stroke, following acute myocardial infarction, congestive heart failure, and mortality. After propensity score matching, there were 663 patients in each group. Compared to that in the control group, the neuroendoscopy and craniotomy groups had a significantly higher risk of secondary vascular events at 1 to 3 months of follow-up (adjusted HR, 2.08 and 1.95; 95% CI, 1.21–3.58 and 1.13–3.35;
p
< 0.01 and
p
< 0.05, respectively), but a significantly lower risk after 3 years of follow-up (adjusted HR, 0.52 and 0.52; 95% CI, 0.35–0.78 and 0.35–0.77;
p
< 0.01 and
p
< 0.01, respectively). The mortality rate was higher in the craniotomy group at 6 to 12 months of follow-up (adjusted HR, 2.18; 95% CI, 1.06–4.49;
p
< 0.05) compared to that in the control group. Thus, a timely surgical intervention for hematoma evacuation is advantageous in preventing secondary vascular events and improving outcomes in the long term. However, greater attention to secondary ischemic stroke following the initial sICH episode is needed.</description><subject>Adult</subject><subject>Aged</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cerebral Hemorrhage - complications</subject><subject>Cerebral Hemorrhage - mortality</subject><subject>Cerebral Hemorrhage - surgery</subject><subject>Cerebral Hemorrhage - therapy</subject><subject>Cerebral infarction</subject><subject>Congestive heart failure</subject><subject>Craniotomy - adverse effects</subject><subject>Craniotomy - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematoma</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Neurobiology</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stroke</subject><subject>Taiwan</subject><subject>Treatment Outcome</subject><subject>Vascular diseases</subject><issn>1933-7213</issn><issn>1878-7479</issn><issn>1878-7479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kctu1TAQhiMEohd4ARbIEhs2BjtOfGGBhCpKKx0JxDmIpeU4k5xUSRxs51R9FZ62TlPKZcHKtub7f8_Mn2UvKHlDCRFvA2WMUkyowumZ51g8yo6pFBKLQqjH6a4YwyKn7Cg7CeGKkJIxJZ9mR4wIKTnnx9nPjRtbvAM_oHPX9-4azxPqRvTFxA7GGNB1F_doO7kxmhHcHNDlGL2x4KHypkcXMDjv96YFtPNgItTo-6Jw_u50c0Tb2bedTWxSgj8k186N75BBG-NbwNtUAvQVondhAhu7A6BtnOubZ9mTxvQBnt-fp9m384-7swu8-fzp8uzDBttCFBHbmktDm6bKeVOL2oLgspCcKMq4sEaxpiqUAFITYkltKeWyrrmtckVrU5GCnWbvV99prgZIBsuAvZ58Nxh_o53p9N-Vsdvr1h0056pgJU8Gr-8NvPsxQ4h66IKFvl83pnMqi7IouSgT-uof9MrNfkzjLRRTTNJy6ShfKZt2Ejw0D81Qopfo9Rq9TtHru-i1SKKXf47xIPmVdQLYCoRUGlvwv__-j-0tJw690A</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Chen, XianXiu</creator><creator>Su, Yuan-Chih</creator><creator>Chen, Chun-Chung</creator><creator>Guo, Jeng-Hung</creator><creator>Wu, Chih-ying</creator><creator>Wei, Sung-Tai</creator><creator>Chen, Der-Cherng</creator><creator>Lin, Jung-Ju</creator><creator>Shieh, Shwn-Huey</creator><creator>Chiu, Cheng-Di</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190701</creationdate><title>Long-Term Follow-up in Patients with Spontaneous Intracerebral Hemorrhage Treated With or Without Surgical Intervention: a Large-Scale Retrospective Study</title><author>Chen, XianXiu ; Su, Yuan-Chih ; Chen, Chun-Chung ; Guo, Jeng-Hung ; Wu, Chih-ying ; Wei, Sung-Tai ; Chen, Der-Cherng ; Lin, Jung-Ju ; Shieh, Shwn-Huey ; Chiu, Cheng-Di</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-cd68a1ffb26fd7dce768486091367ca93fb497e0d00c0dc1168dd6cb291dab043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cerebral Hemorrhage - complications</topic><topic>Cerebral Hemorrhage - mortality</topic><topic>Cerebral Hemorrhage - surgery</topic><topic>Cerebral Hemorrhage - therapy</topic><topic>Cerebral infarction</topic><topic>Congestive heart failure</topic><topic>Craniotomy - adverse effects</topic><topic>Craniotomy - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hematoma</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Neurobiology</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stroke</topic><topic>Taiwan</topic><topic>Treatment Outcome</topic><topic>Vascular diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, XianXiu</creatorcontrib><creatorcontrib>Su, Yuan-Chih</creatorcontrib><creatorcontrib>Chen, Chun-Chung</creatorcontrib><creatorcontrib>Guo, Jeng-Hung</creatorcontrib><creatorcontrib>Wu, Chih-ying</creatorcontrib><creatorcontrib>Wei, Sung-Tai</creatorcontrib><creatorcontrib>Chen, Der-Cherng</creatorcontrib><creatorcontrib>Lin, Jung-Ju</creatorcontrib><creatorcontrib>Shieh, Shwn-Huey</creatorcontrib><creatorcontrib>Chiu, Cheng-Di</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurotherapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, XianXiu</au><au>Su, Yuan-Chih</au><au>Chen, Chun-Chung</au><au>Guo, Jeng-Hung</au><au>Wu, Chih-ying</au><au>Wei, Sung-Tai</au><au>Chen, Der-Cherng</au><au>Lin, Jung-Ju</au><au>Shieh, Shwn-Huey</au><au>Chiu, Cheng-Di</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Follow-up in Patients with Spontaneous Intracerebral Hemorrhage Treated With or Without Surgical Intervention: a Large-Scale Retrospective Study</atitle><jtitle>Neurotherapeutics</jtitle><stitle>Neurotherapeutics</stitle><addtitle>Neurotherapeutics</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>16</volume><issue>3</issue><spage>891</spage><epage>900</epage><pages>891-900</pages><issn>1933-7213</issn><issn>1878-7479</issn><eissn>1878-7479</eissn><abstract>Debates regarding the most beneficial medical or surgical procedures for patients with spontaneous intracerebral hemorrhage (sICH) are still ongoing. We aimed to evaluate the risk of subsequent vascular disease and mortality in patients with sICH treated with and without surgical intervention, in a large-scale Asian population. Patients hospitalized within 2000 to 2013 who were newly diagnosed with sICH were identified using the National Health Insurance Research Database of Taiwan. Neuroendoscopy and craniotomy groups comprised patients who underwent surgical treatment within 1 week, while those in the control group did not undergo early surgical treatment. Outcomes included subsequent hemorrhagic and ischemic stroke, following acute myocardial infarction, congestive heart failure, and mortality. After propensity score matching, there were 663 patients in each group. Compared to that in the control group, the neuroendoscopy and craniotomy groups had a significantly higher risk of secondary vascular events at 1 to 3 months of follow-up (adjusted HR, 2.08 and 1.95; 95% CI, 1.21–3.58 and 1.13–3.35;
p
< 0.01 and
p
< 0.05, respectively), but a significantly lower risk after 3 years of follow-up (adjusted HR, 0.52 and 0.52; 95% CI, 0.35–0.78 and 0.35–0.77;
p
< 0.01 and
p
< 0.01, respectively). The mortality rate was higher in the craniotomy group at 6 to 12 months of follow-up (adjusted HR, 2.18; 95% CI, 1.06–4.49;
p
< 0.05) compared to that in the control group. Thus, a timely surgical intervention for hematoma evacuation is advantageous in preventing secondary vascular events and improving outcomes in the long term. However, greater attention to secondary ischemic stroke following the initial sICH episode is needed.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30788666</pmid><doi>10.1007/s13311-019-00722-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurotherapeutics, 2019-07, Vol.16 (3), p.891-900 |
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| subjects | Adult Aged Biomedical and Life Sciences Biomedicine Cerebral Hemorrhage - complications Cerebral Hemorrhage - mortality Cerebral Hemorrhage - surgery Cerebral Hemorrhage - therapy Cerebral infarction Congestive heart failure Craniotomy - adverse effects Craniotomy - methods Female Follow-Up Studies Hematoma Hemorrhage Humans Ischemia Male Middle Aged Mortality Myocardial infarction Neurobiology Neurology Neurosciences Neurosurgery Original Original Article Patients Propensity Score Retrospective Studies Risk Factors Stroke Taiwan Treatment Outcome Vascular diseases |
| title | Long-Term Follow-up in Patients with Spontaneous Intracerebral Hemorrhage Treated With or Without Surgical Intervention: a Large-Scale Retrospective Study |
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