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Long-Term Outcomes Following Freehand Minimally Invasive Aspiration for Deep Supratentorial Intracerebral Hemorrhage: A Multicenter Cohort Study

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Abstract

Background

The aim of this study was to compare the therapeutic effects of non-navigated freehand minimally invasive aspiration and conservative medical care in patients with deep supratentorial intracerebral hemorrhage (ICH).

Methods

We analyzed data from a prospective multicenter cohort study. Propensity score matching was performed to adjust for possible confounding factors. A total of 122 patients with first-onset deep supratentorial ICH with a volume ≥ 20 ml were enrolled. All patients were followed up at 30 days, 90 days, and 1 year. The mortality rate, functional outcomes, complications, and treatment costs were compared between the two groups.

Results

After propensity score matching, 122 patients with a mean age of 56.0 years were included, 77.9% of whom were male. The median ICH volumes were 45.5 ml in the surgery group and 48.0 ml in the conservative group. The mortality rate at 30 days was significantly lower in the surgery group than in the conservative group (P = 0.0127). There were no significant differences in functional outcomes at the 90-day and 1-year follow-ups between the two groups (P > 0.05). There was no significant difference in complications, including recurrent bleeding (6.6% vs. 4.9%), pulmonary infection (57.4% vs. 41.0%), deep venous thrombosis (9.8% vs. 11.5%), heart failure (1.6% vs. 6.6%), and cerebral infarction (4.9% vs. 3.3%), between the two groups.

Discussion

For deep supratentorial ICH, non-navigated freehand minimally invasive aspiration was safe and reduced short-term mortality but did not effectively improve long-term functional outcomes.

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Data Availability

Research data are not shared because of ethical restrictions.

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Acknowledgements

We would like to that the cooperation of the hospitals that took part in our program and for helping collect the information of patients.

Funding

This work was supported by the National Key R&D Program of China (2022ZD0118005), the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2019-I2M-5–029), Beijing Municipal Committee of Science and Technology (Z201100005620010), Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support (202112), and the Ministry of Finance of the People’s Republic of China (issued by Finance and Social Security [2015] Document No. 82 [2016], Document No. 50 [2017], Document No. 72 [2018], Document No. 48 [2019], Document No. 77 [2020], Document No. 75 [2021], and Document No. 84, Ministry of Finance).

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Author notes

  1. Authors Xingquan Zhao and Wenjuan Wang contributed equally as co-corresponding authors.

Authors and Affiliations

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fanyang Street 119, Beijing, 100070, China

    Jiahuan Guo, Dandan Wang, Anxin Wang, Xingquan Zhao & Wenjuan Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Anxin Wang, Xiaoli Zhang & Xingquan Zhao

  3. Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China

    Xingquan Zhao

  4. Center of Stroke, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China

    Xingquan Zhao

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  1. Jiahuan Guo
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  2. Dandan Wang
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  3. Anxin Wang
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  4. Xiaoli Zhang
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  5. Xingquan Zhao
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  6. Wenjuan Wang
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Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; drafted the article or revised it critically for important intellectual content; and approved the final version to be published.

Corresponding authors

Correspondence to Xingquan Zhao or Wenjuan Wang.

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The authors declare that they have no conflicts of interest.

Ethics Approval/Informed Consent

This study was approved by the Institutional Review Board of Beijing Tiantan Hospital. Written informed consent was obtained from all participants or their relatives.

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Guo, J., Wang, D., Wang, A. et al. Long-Term Outcomes Following Freehand Minimally Invasive Aspiration for Deep Supratentorial Intracerebral Hemorrhage: A Multicenter Cohort Study. Neurocrit Care (2023). https://doi.org/10.1007/s12028-023-01869-0

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  • DOI: https://doi.org/10.1007/s12028-023-01869-0

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