Increased Perioperative Crystalloid Transfusion Is Associated with Better Outcomes After Spontaneous Hypertensive Putamen Hemorrhage: A Retrospective Study.
BACKGROUND
The appropriate amount of transfused fluids, and which types of fluids should be transfused during the peri-operative period, is a matter of controversy among neurosurgeons. Thus, a retrospective study was conducted to assess whether crystalloid transfusion is associated with better outcomes after spontaneous hypertensive putamen hemorrhage (HPH).


METHODS
Data from acute spontaneous HPH surgeries performed between December 2013 and June 2016 were collected in a multi-center chart. The primary outcome was prognosis, with better outcome defined as a Glasgow outcome score (GOS) of 4 or greater. The secondary outcome was survival, with survival defined as a GOS score of 2 or greater. Univariate analysis and bivariate logistic regression were performed to account for the association between perioperative HPH and different outcomes. We also used Spearman rank correlation and linear regression to determine the correlation between length of stay (LOS) and the univariate analysis significant factors in patients with a GOS score of 4 or greater.


RESULTS
Bivariate logistic regression showed a marked correlation between better outcome and age (odds ratio [OR], 0.927; 95% confidence interval [CI], 0.851-0.995), Glasgow Coma Scale (GCS; OR, 1.162; 95% CI, 1.049-1.356), and crystalloid transfusion (OR, 1.083; 95% CI, 1.005-1.142). In addition, bivariate logistic regression also revealed a significant correlation between survival and GCS score (OR, 1.097; 95% CI, 1.056-1.199). In patients with a GOS of 4 or greater, Spearman rank correlation and linear regression suggested that a higher GCS score was more likely to prolong the LOS.


CONCLUSIONS
Increased perioperative crystalloid transfusion was independently associated with better outcome across a spectrum of surgical risk profiles after spontaneous HPH.
Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, China. Electronic address: azai2010@126.com.
Li-Min
LM
Zhang
Department of Anesthesiology, Shengjing Hospital, Shenyang, China.
Xiao-Chun
XC
Zhao
Department of Anesthesiology, Cangzhou second people Hospital, Cangzhou, China.
Qian
Q
Zhang
Department of Anesthesiology, General Hospital of Huabei Petroleum Administration Bureau, Renqiu, China.
Luo
L
Xing-Liao
D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000379:methods*; D000077324:Crystalloid Solutions; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality; D007552:Isotonic Solutions / Q000627:therapeutic use*; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D020146:Putaminal Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions
Crystalloid; Glasgow outcome score; Hypertensive intracerebral hemorrhage