Comparative evaluation of the results of conservative and surgical treatment of patients with hypertensive intracerebral hemorrhages

Abstract

Aim. Comparative evaluation of 30-day survival in patients with hypertensive intracerebral hemorrhages
(HIH) after conservative and surgical treatment.
Material and methods. A comparative analysis of the results of conservative and surgical treatment of
140 patients with HIH was carried out, 52 (37.1%) patients of them were female, 88 (62.9%) were male.
The average age is 58.8±14.0 years. The patients were divided into 2 groups: group 1 – patients with conservative treatment (n=60), group 2 – patients with surgical treatment (n=80).
Results. The 30-day survival rate is higher in patients with conservative treatment due to small volumes of hematoma, in patients with surgical treatment – with large volumes. In patients with conservative treatment with a volume of HIH up to 10 cm3
, the 30-day survival rate was 92,9%, with a volume of
11-20 cm3
– 63,6%, with a volume of 21-30 cm3
– 50%, with a volume of 31-40 cm3
– 0% (χ2
=29.9
p<0.01). In patients with surgical treatment with a volume of HIH up to 10 cm3
, the 30-day survival rate was
50%, with a volume of 11-20 cm3
– 70,8%, with a volume of 21-30 cm3
– 82,4%, with a volume of 31-
40 cm3
– 41,9% (χ2
=8.3 p<0.05). The 30-day survival rate for small volumes in the intravenrticular hemorrhage (IVH), estimated by the mGS, is higher than for large volumes. In patients with conservative treatment
with 0 points by the mGS the 30-day survival rate was 91,4%, with 3 points – 50%, with 6 points – 33,3%,
with 8 points – 0% (χ2
=24.4 p<0.01). In patients with surgical treatment with 0 points on the mGS the 30-day
survival rate was 94%, with 3 points – 57,1%, with 6 points – 44,4%, with 8 points – 33,3% (χ2
=24.5 p<0.01).
Conclusion. The choice of a surgical or conservative treatment method can be carried out on the basis of
volume indicators of hematoma and the severity of IVH.