title: Survival analysis of surgically evacuated supratentorial spontaneous intracerebral hemorrhage with intraventricular extension.
abstract: To conduct a survival study and evaluation of surgical treatment in a cohort of patients with diagnosis of supratentorial spontaneous intracerebral hemorrhage (ICH).
  
  
  
  The study included all consecutive patients with supratentorial ICH admitted to the Intensive Care Units of three Spanish hospitals with Neurosurgery Department between 2009 and 2012.
  
  
  
  age, APACHE-II, Glasgow Coma Score (GCS), and pupillary anomalies on admission, intracerebral hemorrhage (ICH) score, location/volume of hematoma, intraventricular hemorrhage (IVH), surgical evacuation alone or with additional external ventricular drain, and 30-days survival and at hospital discharge
  
  
  
  A total of 263 patients were included. Mean age: 59.74±14.14 years. GCS: 8±4 points, APACHE II: 20.7±7.68 points. ICH Score: 2.32+1.04 points. Pupillary anomalies were observed in 30%. The 30-day mortality: 51.3% (45.3% predicted by ICH-score), and 53.2% at hospital discharge. A significant difference (p=0.004) was observed in hospital mortality rates between surgically treated patients (39.7%, n=78) versus those conservatively managed (58.9%, n=185); specifically in those with IVH surgically treated (34.2%, n=38) versus non-operated IVH (67.2%, n=125), p<0.001. No significant difference was found between mortality rates in patients without IVH. Multiple logistic regression analysis showed an OR for surgery of 1.04 (95% CI; 0.33-3.22) in patients without IVH versus 0.19 (95% CI; 0.07-0.53) in patients with IVH (decreased mortality with surgical treatment). The propensity score analysis for IVH patients showed improved survival of operated group (OR 0.23, 95% CI; 0.07-0.75), p=0.01.
  
  
  
  Hospital mortality was lower in patients who underwent surgery compared to patients conservatively managed, specifically for the subgroup of patients with intraventricular hemorrhage.
authors.affiliation: Intensive Care Medicine, Hospital de la Serranía, Ronda, Málaga, Spain.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Rivera-Fernández
authors.affiliation: Intensive Care Medicine, Hospital Virgen de las Nieves, Granada, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Guerrero-López
authors.affiliation: Neurosurgery Department, Hospital del Mar, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Rodríguez-Rubio
authors.affiliation: Universidad de Granada, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Gómez-Jiménez
authors.affiliation: Intensive Care Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodríguez-Vilanova
authors.affiliation: Intensive Care Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Mora-Ordóñez
authors.affiliation: Intensive Care Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Olea-Jiménez
authors.affiliation: Intensive Care Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Arias-Verdú
authors.affiliation: Intensive Care Medicine, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Quesada-García
authors.affiliation: Intensive Care Medicine, Hospital Neurotraumatológico, Jaén, Spain.
authors.forename: Faustino
authors.initials: F
authors.lastname: Acebal-Blanco
authors.affiliation: Intensive Care Medicine, Hospital Neurotraumatológico, Jaén, Spain. Electronic address: encarnacioncastillo@gmail.com.
authors.forename: Encarnación
authors.initials: E
authors.lastname: Castillo-Lorente
authors.affiliation: Neurosurgery Department, Hospital Carlos Haya, Málaga, Spain.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arráez-Sánchez
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000601:surgery; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cirugía; Hemorragia intracerebral; Intracerebral hemorrhage; Surgery; Tratamiento; Treatment