OUTCOME OF PATIENTS IN EARLY SURGICAL INTERVENTION IN SPONTANEOUS INTRACEREBRAL HEMORRHAGE

Abstract

OBJECTIVE: To evaluate post-treatment outcomes in patients with intracerebral hemorrhage and analyze the differences between surgical and conservative management.
METHODOLGY: This scholarly research was undertaken at LUMHS in Jamshoro, with a focus on individuals within the age range of 30 to 55 years, irrespective of gender, who have received a diagnosis of intracerebral hemorrhage (ICH). Utilizing a non-probability consecutive sampling methodology, participants were allocated to either surgical or conservative intervention, with the choice of treatment modality being determined by the attending neurosurgeon in alignment with their clinical presentation. The study was designed to evaluate functional recovery (mRS ≤2) and mortality as the primary endpoints. Data was systematically entered and analyzed utilizing SPSS version 26. Descriptive statistics will be computed, and data will be analyzed and presented with a 95% confidence interval.
RESULTS: Among a cohort of 182 patients diagnosed with intracerebral hemorrhage (mean age: 43.29 ± 7.21 years in the surgical intervention group; 42.65 ± 7.55 in the conservative management group), the male demographic constituted 58.2% and 47.2%, respectively. The application of surgical management yielded statistically significant superior outcomes: a decreased mortality rate (5.5% versus 21.3%; p=0.005), enhanced functional recovery (70.9% versus 48.0%; p=0.004), a reduced duration of hospitalization (10.64 ± 2.04 versus 12.90 ± 4.27 days; p=0.0001), and a diminished requirement for long-term care services (9.1% versus 41.7%; p=0.0001).

CONCLUSION: This research elucidated that prompt surgical intervention in individuals experiencing spontaneous intracerebral hemorrhage significantly enhances clinical outcomes, which encompass reduced mortality rates, improved functional recovery (mRS ≤2), diminished occurrences of neurological deterioration and radiological progression, as well as a decreased length of hospital stay. Furthermore, a smaller proportion of patients necessitated long-term care. These findings substantiate the efficacy of early surgical management compared to conservative treatment in appropriately selected patients, thereby highlighting its capacity to facilitate recovery and mitigate complications associated with spontaneous ICH.