The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude

Purpose: Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Lin-Jie Wei, Chi Lin, Xing-Sen Xue, Guo-Dong Dun, Jian-Bo Zhang, Yan-Xiang Tong, Jia-Xiong Wang, Shi-Ji Yang, Ling Wang, Zhi Chen, Hua Feng, Gang Zhu
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://doaj.org/article/98401608022348f7b1dc2b7fb9e3924b
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:98401608022348f7b1dc2b7fb9e3924b
record_format dspace
spelling oai:doaj.org-article:98401608022348f7b1dc2b7fb9e3924b2021-11-18T04:43:48ZThe effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude1008-127510.1016/j.cjtee.2021.08.006https://doaj.org/article/98401608022348f7b1dc2b7fb9e3924b2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1008127521001309https://doaj.org/toc/1008-1275Purpose: Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic effect and thus compared the combined surgery with DC alone. Methods: From December 2013 to July 2019, patients with HICH from Linzhi, Tibet and Honghe, Yunnan Province were retrospectively analyzed. The selection criteria were as follows: (1) altitude ≥1500 m; (2) HICH patients with cerebral hernia; (3) Glascow coma scale score of 4–8 and time from onset to admission ≤3 h; (4) good liver and kidney function; and (5) complete case data. The included patients were divided into DC group and PD + DC group. The patients were followed up for 6 months. The outcome was assessed by Glasgow outcome scale (GOS) score, Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis. A good outcome was defined as independent (GOS score, 4-5) and poor outcome defined as dependent (GOS score, 3-1). All data analyses were performed using SPSS 19, and comparison between two groups was conducted using separate t-tests or Chi-square tests. Results: A total of 65 patients was included. The age ranged 34-90 years (mean, 63.00 ± 14.04 years). Among them, 31 patients had the operation of PD + DC, whereas 34 patients underwent DC. The two groups had no significant difference in the basic characteristics. After 6 months of follow-up, in the PD + DC group there were 8 death, 4 vegetative state, 4 severe disability (GOS score 1-3, poor outcome 51.6 %); 8 moderate disability, and 7 good recovery (GOS score 4-5, good outcome 48.4 %); while in the DC group the result was 15 death, 6 vegetative state, 5 severe disability (poor outcome 76.5 %), 4 moderate disability and 4 good recovery (good outcome 23.5 %). The GOS score and good outcome were significantly less in DC group than in PD + DC group (Z = −1.993, p = 0.046; χ2 = 4.38, p = 0.043). However, there was no significant difference regarding the survival curve between PD + DC group and DC group. The correlation between the time from admission to operation and GOS at 6 months (r = −0.41, R2 = 0.002, p = 0.829) was not significant in the PD + DC group, but significant in the DC group (r = −0.357, R2 = 0.128, p = 0.038). Conclusion: PD + DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude.Lin-Jie WeiChi LinXing-Sen XueGuo-Dong DunJian-Bo ZhangYan-Xiang TongJia-Xiong WangShi-Ji YangLing WangZhi ChenHua FengGang ZhuElsevierarticleIntracranial hemorrhageHypertensiveHigh altitudeCerebral herniaHematoma puncture drainageDecompressive craniectomyMedicine (General)R5-920ENChinese Journal of Traumatology, Vol 24, Iss 6, Pp 328-332 (2021)
institution DOAJ
collection DOAJ
language EN
topic Intracranial hemorrhage
Hypertensive
High altitude
Cerebral hernia
Hematoma puncture drainage
Decompressive craniectomy
Medicine (General)
R5-920
spellingShingle Intracranial hemorrhage
Hypertensive
High altitude
Cerebral hernia
Hematoma puncture drainage
Decompressive craniectomy
Medicine (General)
R5-920
Lin-Jie Wei
Chi Lin
Xing-Sen Xue
Guo-Dong Dun
Jian-Bo Zhang
Yan-Xiang Tong
Jia-Xiong Wang
Shi-Ji Yang
Ling Wang
Zhi Chen
Hua Feng
Gang Zhu
The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
description Purpose: Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic effect and thus compared the combined surgery with DC alone. Methods: From December 2013 to July 2019, patients with HICH from Linzhi, Tibet and Honghe, Yunnan Province were retrospectively analyzed. The selection criteria were as follows: (1) altitude ≥1500 m; (2) HICH patients with cerebral hernia; (3) Glascow coma scale score of 4–8 and time from onset to admission ≤3 h; (4) good liver and kidney function; and (5) complete case data. The included patients were divided into DC group and PD + DC group. The patients were followed up for 6 months. The outcome was assessed by Glasgow outcome scale (GOS) score, Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis. A good outcome was defined as independent (GOS score, 4-5) and poor outcome defined as dependent (GOS score, 3-1). All data analyses were performed using SPSS 19, and comparison between two groups was conducted using separate t-tests or Chi-square tests. Results: A total of 65 patients was included. The age ranged 34-90 years (mean, 63.00 ± 14.04 years). Among them, 31 patients had the operation of PD + DC, whereas 34 patients underwent DC. The two groups had no significant difference in the basic characteristics. After 6 months of follow-up, in the PD + DC group there were 8 death, 4 vegetative state, 4 severe disability (GOS score 1-3, poor outcome 51.6 %); 8 moderate disability, and 7 good recovery (GOS score 4-5, good outcome 48.4 %); while in the DC group the result was 15 death, 6 vegetative state, 5 severe disability (poor outcome 76.5 %), 4 moderate disability and 4 good recovery (good outcome 23.5 %). The GOS score and good outcome were significantly less in DC group than in PD + DC group (Z = −1.993, p = 0.046; χ2 = 4.38, p = 0.043). However, there was no significant difference regarding the survival curve between PD + DC group and DC group. The correlation between the time from admission to operation and GOS at 6 months (r = −0.41, R2 = 0.002, p = 0.829) was not significant in the PD + DC group, but significant in the DC group (r = −0.357, R2 = 0.128, p = 0.038). Conclusion: PD + DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude.
format article
author Lin-Jie Wei
Chi Lin
Xing-Sen Xue
Guo-Dong Dun
Jian-Bo Zhang
Yan-Xiang Tong
Jia-Xiong Wang
Shi-Ji Yang
Ling Wang
Zhi Chen
Hua Feng
Gang Zhu
author_facet Lin-Jie Wei
Chi Lin
Xing-Sen Xue
Guo-Dong Dun
Jian-Bo Zhang
Yan-Xiang Tong
Jia-Xiong Wang
Shi-Ji Yang
Ling Wang
Zhi Chen
Hua Feng
Gang Zhu
author_sort Lin-Jie Wei
title The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
title_short The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
title_full The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
title_fullStr The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
title_full_unstemmed The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
title_sort effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude
publisher Elsevier
publishDate 2021
url https://doaj.org/article/98401608022348f7b1dc2b7fb9e3924b
work_keys_str_mv AT linjiewei theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT chilin theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT xingsenxue theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT guodongdun theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT jianbozhang theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT yanxiangtong theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT jiaxiongwang theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT shijiyang theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT lingwang theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT zhichen theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT huafeng theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT gangzhu theeffectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT linjiewei effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT chilin effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT xingsenxue effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT guodongdun effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT jianbozhang effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT yanxiangtong effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT jiaxiongwang effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT shijiyang effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT lingwang effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT zhichen effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT huafeng effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
AT gangzhu effectofhematomapuncturedrainagebeforedecompressivecraniectomyontheprognosisofhypertensiveintracerebralhemorrhagewithcerebralherniaatahighaltitude
_version_ 1718425117356195840