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Differences in neur...
Differences in neurosurgical treatment of intracerebral haemorrhage: a nation-wide observational study of 578 consecutive patients
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- Fahlström, Andreas (författare)
- Uppsala University,Uppsala universitet,Neurokirurgi,Uppsala University Hospital
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- Tobieson, Lovisa (författare)
- Linköping University,Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten,Region Östergötland, Neurokirurgiska kliniken US,Linkoping Univ, Dept Neurosurg, Linkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden
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- Redebrandt, Henrietta Nittby (författare)
- Lund University,Lunds universitet,Neurokirurgi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurosurgery,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Zeberg, H. (författare)
- Karolinska Institute,Karolinska Institutet
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- Bartek, J. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital,Copenhagen University Hospital
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- Bartley, Andreas (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience,Department of Clinical Neuroscience, Neurosurgery, University of Gothenburg, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Univ Hosp, Sahlgrenska Acad, Dept Clin Neurosci,Neurosurg, Gothenburg, Sweden
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- Erkki, M. (författare)
- Umeå University,Umeå universitet,Klinisk neurovetenskap,Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå University Hospital, Umeå, Sweden,Umea Univ, Umea Univ Hosp, Dept Clin Neurosci, Neurosurg, Umea, Sweden,Norrland University Hospital
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- Hessington, A. (författare)
- Uppsala University,Uppsala universitet,Neurokirurgi,Uppsala University Hospital
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- Troberg, Ebba (författare)
- Lund University,Lunds universitet,Neurokirurgi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurosurgery,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Mirza, S. (författare)
- Karolinska Institute
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- Tsitsopoulos, Parmenion P. (författare)
- Uppsala University,Uppsala universitet,Neurokirurgi,Uppsala University Hospital
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- Marklund, Niklas (författare)
- Lund University,Lunds universitet,Uppsala University,Linköping University,Uppsala universitet,Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten,Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, Uppsala, Sweden; Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden,Neurokirurgi,Linkoping Univ, Dept Neurosurg, Linkoping, Sweden;Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Neurosurg, Lund, Sweden,LUBIN Lab- Lunds laboratorium för neurokirurgisk hjärnskadeforskning,Forskargrupper vid Lunds universitet,LUBIN Lab- Lund Brain Injury laboratory for Neurosurgical research,Lund University Research Groups
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(creator_code:org_t)
- 2019-03-15
- 2019
- Engelska.
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Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 161:5, s. 955-965
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Abstract
Ämnesord
Stäng
- BackgroundSupratentorial intracerebral haemorrhage (ICH) carries an excessive mortality and morbidity. Although surgical ICH treatment can be life-saving, the indications for surgery in larger cohorts of ICH patients are controversial and not well defined. We hypothesised that surgical indications vary substantially among neurosurgical centres in Sweden.ObjectiveIn this nation-wide retrospective observational study, differences in treatment strategies among all neurosurgical departments in Sweden were evaluated.MethodsPatient records, neuroimaging and clinical outcome focused on 30-day mortality were collected on each operated ICH patient treated at any of the six neurosurgical centres in Sweden from 1 January 2011 to 31 December 2015.ResultsIn total, 578 consecutive surgically treated ICH patients were evaluated. There was a similar incidence of surgical treatment among different neurosurgical catchment areas. Patient selection for surgery was similar among the centres in terms of patient age, pre-operative level of consciousness and co-morbidities, but differed in ICH volume, proportion of deep-seated vs. lobar ICH and pre-operative signs of herniation (p<.05). Post-operative patient management strategies, including the use of ICP-monitoring, CSF-drainage and mechanical ventilation, varied among centres (p<.05). The 30-day mortality ranged between 10 and 28%.ConclusionsAlthough indications for surgical treatment of ICH in the six Swedish neurosurgical centres were homogenous with regard to age and pre-operative level of consciousness, important differences in ICH volume, proportion of deep-seated haemorrhages and pre-operative signs of herniation were observed, and there was a substantial variability in post-operative management. The present results reflect the need for refined evidence-based guidelines for surgical management of ICH.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Intracerebral haemorrhage
- Surgery
- Guidelines
- Craniotomy
- External ventricular drain
- Intraventricular haemorrhage
- initial conservative treatment
- early surgical-treatment
- intraventricular hemorrhage
- international variations
- putaminal
- hemorrhage
- early surgery
- management
- stich
- hematomas
- trial
- Neurosciences & Neurology
- Surgery
- Intracerebral haemorrhage
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Av författaren/redakt...
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Fahlström, Andre ...
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Tobieson, Lovisa
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Redebrandt, Henr ...
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Zeberg, H.
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Bartek, J.
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Bartley, Andreas
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visa fler...
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Erkki, M.
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Hessington, A.
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Troberg, Ebba
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Mirza, S.
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Tsitsopoulos, Pa ...
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Marklund, Niklas
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Medicinska och f ...
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och Neurovetenskaper
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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Göteborgs universitet
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Umeå universitet
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