Analysis Of Factors Correlated With Prognosis Of Supratentorial Intracerebral Hemorrhage After Minimal Invasive Hematoma Aspiration And Fibrinolysis

ObjectiveThe aims of this study were to investigate the clinical features and operative techniques which influence the prognosis of supratentorial intracerebral hemorrhage after minimal invasive hematoma aspiration and fibrinolysis,and provide clinical reference for postoperative outcomes and specification for surgical procedure.MethodsThe subjects were the patients with cerebral hemorrhage underwent minimal invasive hematoma aspiration and fibrinolysis in our department from January 2006 to October 2010. The clinical features (general information, blood pressure on admission, preoperative GCS , postoperative GCS, baseline hematoma volume, hematoma location and rebleeding) and the information of surgical procedure (time for surgery, first aspiration rate, time for needle extraction, hematoma clearance rate and speed) were recorded by screening . We followed up the prognosis (GOS) in the 6th month after operation, and found out the clinical features and operative techniques which influence the prognosis by univariate analysis and Logistic regression analysis.Results In the 6th month after operation, 18 patients had GOS5 (13.1%), 43 patients had GOS4 (31.4%), 40 patients had GOS3 (29.2%), 4 patients had GOS2 (2.9%), and 32 patients had GOS1 (23.4%).Results of univariate analysis: There were significant differences in the prognosis between different groups in hematoma volume (p=0.002), preoperative GCS (p<0.001), postoperative GCS (p<0.001) and hematoma location (p=0.001). Different prognosis between groups of different clearance rate and speed were found (p < 0.001, p=0.001). Rebleeding patients had poor prognosis (mortality is 75.0%). No significant difference between different groups in gender, age, systolic blood pressure, time for surgery and time for needle extraction.Results of Logistic regression analysis: age, hematoma location, preoperative GCS, hematoma clearance rate and rebleeding were the independent predictors of prognosis.ConclusionIn the patients underwent minimal invasive hematoma aspiration and fibrinolysis for supratentorial intracerebral hemorrhage, old age, large hematoma, low preoperative GCS and deep hematoma predict poor prognosis. In the operation, first aspiration rate did not influence the prognosis. The more the clearance of hematoma, the better the prognosis was. But rebleeding must be alert to. Patients with postoperative rebleeding had poor prognosis.