Which factors influence decisions to transfer and treat patients with acute intracerebral haemorrhage and which are associated with prognosis? A retrospective cohort study

BMJ Open
Kamran A AbidAdrian R Parry-Jones

Abstract

To identify factors associated with the decision to transfer and/or operate on patients with intracerebral haemorrhage (ICH) at a UK regional neurosurgical centre and test whether these decisions were associated with patient survival. Retrospective cohort study. 14 acute and specialist hospitals served by the neurosurgical unit at Salford Royal NHS Foundation Trust, Salford, UK. All patients referred acutely to neurosurgery from January 2008 to October 2010. Primary outcome was survival and secondary outcomes were transfer to the neurosurgical centre and acute neurosurgery. We obtained clinical data from 1364 consecutive spontaneous patients with ICH and 1175 cases were included in the final analysis. 140 (12%) patients were transferred and 75 (6%) had surgery. In a multifactorial analysis, the decision to transfer was more likely with younger age, women, brainstem and cerebellar location and larger haematomas. Risk of death in the following year was higher with advancing age, lower Glasgow Coma Scale, larger haematomas, brainstem ICH and intraventricular haemorrhage. The transferred patients had a lower risk of death relative to those remaining at the referring centre whether they had surgery (HR 0.46, 95% CI 0.32 to 0.67) or ...Continue Reading

Citations

Sep 17, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Elvis CamachoE Sander Connolly
Jan 15, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Adrian R Parry-JonesUNKNOWN SSNAP Collaborative Group
Nov 5, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Inger de RidderHagen B Huttner
Dec 23, 2020·Stroke; a Journal of Cerebral Circulation·Henry ZhaoBruce C V Campbell

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