Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study
Introduction: Spontaneous intracerebral haemorrhage (sICH) is a major cause of morbidity and mortality. Large-scale trials have shown neutral outcomes for surgical interventions. The recent trial suggested functional benefits from surgical intervention. Surgical treatment for sICH is likely increasi...
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Elsevier
2024-01-01
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| Series: | Brain and Spine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S277252942400170X |
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| author | Sami Lehto Antti Sajanti Santtu Hellström Fredrika Koskimäki Abhinav Srinath Carolyn Bennett Julián Carrión-Penagos Ying Cao Miro Jänkälä Romuald Girard Jaakko Rinne Melissa Rahi Janne Koskimäki |
| author_facet | Sami Lehto Antti Sajanti Santtu Hellström Fredrika Koskimäki Abhinav Srinath Carolyn Bennett Julián Carrión-Penagos Ying Cao Miro Jänkälä Romuald Girard Jaakko Rinne Melissa Rahi Janne Koskimäki |
| author_sort | Sami Lehto |
| collection | DOAJ |
| description | Introduction: Spontaneous intracerebral haemorrhage (sICH) is a major cause of morbidity and mortality. Large-scale trials have shown neutral outcomes for surgical interventions. The recent trial suggested functional benefits from surgical intervention. Surgical treatment for sICH is likely increasing. Research question: To determine the incidence of sICH in Southwest Finland, standardized to the European population, and to identify the proportion of large sICH patients eligible for surgery based on previously published trial criteria. We also examined factors associated with outcomes, including the effects of anticoagulant and antithrombotic medications. Material and methods: A retrospective clinical study identified 596 ICH cases treated at Turku University Hospital (2018–2019), of which 286 were supratentorial sICHs. Variables were analysed using a t-test, chi-squared or Fisher's exact test. A multivariate logistic modelling was performed to evaluate outcome differences. Results: The sICH incidence was 29.9/100,000 persons per year, with the highest European population age and sex standardized rates in individuals over 80 years old (110/100,000 males, 142/100,000 females). The incidence of sICH patients meeting surgical criteria was 2.7/100,000 persons per year. Out of 286 patients, 26 were eligible for surgery and had unfavourable outcomes (p = 0.0049). Multivariate analysis indicated a significant decrease in favourable outcomes with warfarin (p = 0.016, OR 0.42) and direct-acting anticoagulants (DOACs) (p = 0.034, OR 0.38), while antithrombotic medications showed no significant effect. Discussion and conclusion: We identified comparable incidence of sICH as European average. A small proportion of sICH cases were identified to be candidates for surgical intervention. Anticoagulants were associated with increased risk of unfavourable outcomes. |
| format | Article |
| id | doaj-art-b1cadb6cb3b54e2aa6dc1afe9c4756c1 |
| institution | Kabale University |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-b1cadb6cb3b54e2aa6dc1afe9c4756c12024-12-15T06:18:41ZengElsevierBrain and Spine2772-52942024-01-014102914Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective studySami Lehto0Antti Sajanti1Santtu Hellström2Fredrika Koskimäki3Abhinav Srinath4Carolyn Bennett5Julián Carrión-Penagos6Ying Cao7Miro Jänkälä8Romuald Girard9Jaakko Rinne10Melissa Rahi11Janne Koskimäki12Neurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, FinlandNeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, FinlandNeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, FinlandNeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, Finland; Medical Research Center, Research Unit of Clinical Medicine, University of Oulu, Department of Ophthalmology, Oulu University Hospital, Oulu, FinlandNeurovascular Surgery Program, Section of Neurosurgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USANeurovascular Surgery Program, Section of Neurosurgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USADepartment of Neurology, University of Chicago Medicine and The University of Chicago, IL, USADepartment of Radiation Oncology, Kansas University Medical Center, Kansas City, KS, USADepartment of Neurosurgery, Oulu University Hospital and University of Oulu, FinlandNeurovascular Surgery Program, Section of Neurosurgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USANeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, FinlandNeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, FinlandNeurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, Finland; Department of Neurosurgery, Oulu University Hospital and University of Oulu, Finland; Corresponding author. Neurocenter, Department of Neurosurgery, Turku University Hospital and University of Turku, P.O. Box 52 (Hämeentie 11), FI-20521, Turku, Finland.Introduction: Spontaneous intracerebral haemorrhage (sICH) is a major cause of morbidity and mortality. Large-scale trials have shown neutral outcomes for surgical interventions. The recent trial suggested functional benefits from surgical intervention. Surgical treatment for sICH is likely increasing. Research question: To determine the incidence of sICH in Southwest Finland, standardized to the European population, and to identify the proportion of large sICH patients eligible for surgery based on previously published trial criteria. We also examined factors associated with outcomes, including the effects of anticoagulant and antithrombotic medications. Material and methods: A retrospective clinical study identified 596 ICH cases treated at Turku University Hospital (2018–2019), of which 286 were supratentorial sICHs. Variables were analysed using a t-test, chi-squared or Fisher's exact test. A multivariate logistic modelling was performed to evaluate outcome differences. Results: The sICH incidence was 29.9/100,000 persons per year, with the highest European population age and sex standardized rates in individuals over 80 years old (110/100,000 males, 142/100,000 females). The incidence of sICH patients meeting surgical criteria was 2.7/100,000 persons per year. Out of 286 patients, 26 were eligible for surgery and had unfavourable outcomes (p = 0.0049). Multivariate analysis indicated a significant decrease in favourable outcomes with warfarin (p = 0.016, OR 0.42) and direct-acting anticoagulants (DOACs) (p = 0.034, OR 0.38), while antithrombotic medications showed no significant effect. Discussion and conclusion: We identified comparable incidence of sICH as European average. A small proportion of sICH cases were identified to be candidates for surgical intervention. Anticoagulants were associated with increased risk of unfavourable outcomes.http://www.sciencedirect.com/science/article/pii/S277252942400170XIntracerebral haemorrhageICHIncidenceSurgeryAnticoagulantsOutcome |
| spellingShingle | Sami Lehto Antti Sajanti Santtu Hellström Fredrika Koskimäki Abhinav Srinath Carolyn Bennett Julián Carrión-Penagos Ying Cao Miro Jänkälä Romuald Girard Jaakko Rinne Melissa Rahi Janne Koskimäki Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study Brain and Spine Intracerebral haemorrhage ICH Incidence Surgery Anticoagulants Outcome |
| title | Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study |
| title_full | Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study |
| title_fullStr | Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study |
| title_full_unstemmed | Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study |
| title_short | Incidence, surgical eligibility and outcome of spontaneous intracerebral haemorrhage in Southwest Finland – A retrospective study |
| title_sort | incidence surgical eligibility and outcome of spontaneous intracerebral haemorrhage in southwest finland a retrospective study |
| topic | Intracerebral haemorrhage ICH Incidence Surgery Anticoagulants Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S277252942400170X |
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