SynthesisJAMA2019
Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage.
Synthesis in JAMA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 177 citations in OpenAlex.
- Application of causal inference methods in individual-participant data meta-analyses in medicine: addressing data handling and reporting gaps with new proposed reporting guidelines.BMC medical research methodology · 2024Pooled it
- Pooled it
- The Function of Tranexamic Acid to Prevent Hematoma Expansion After Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis From Randomized Controlled Trials.Frontiers in neurology · 2021Pooled it
- Therapeutic Potential of Traditional Chinese Herbal Medicines in Intracerebral Haemorrhage: A Narrative Review.Neurology and therapy · 2026Review
- Age-Related Volumetric Changes of the Posterior Cranial Fossa and its Structures in Stroke Patients.Cerebellum (London, England) · 2026Article
- Effectiveness and Safety of Minimally Invasive Surgery for Infratentorial Hemorrhages: A Meta-Analysis of Clinical and Technical Outcomes.Asian journal of neurosurgery · 2026Review
- Endothelial Cell TRIM47 Triggers Blood-Brain Barrier Disruption via CYLD Ubiquitination Degradation in an Intracerebral Hemorrhage Model.Neuroscience bulletin · 2026Article
- Failed resolution of inflammation in intracerebral haemorrhage.Nature reviews. Neurology · 2026Review
- Incidence, clinical characteristics and outcome of spontaneous cerebellar intracerebral haemorrhage in a Norwegian population.European stroke journal · 2026Article
- Treatment strategies, complications, and outcomes in spontaneous cerebellar hemorrhage: a swedish observational single-center study.Acta neurochirurgica · 2026Observational
- Active-targeted nano-hemostatic for hemostasis and brain microenvironment optimization in intracerebral hemorrhage therapy.Materials today. Bio · 2026Article
- Article
- Review
- [In-hospital management of intracerebral hemorrhage].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Article
- Comparative study of the conservative and surgical treatment of spontaneous cerebellar hemorrhage.Frontiers in neurology · 2025Article
- Microglial Lcn2 knockout enhances chronic intracerebral hemorrhage recovery by restoring myelin and reducing inflammation.Theranostics · 2025Article
- Minimally invasive surgery and neurophysiological monitoring for brainstem hemorrhage: Advancing predictive models with qEEG and TCD.PloS one · 2025Article
- Intracerebral haemorrhage - mechanisms, diagnosis and prospects for treatment and prevention.Nature reviews. Neurology · 2024Review
- Survivorship After Neurocritical Care: A Scoping Review of Outcomes Beyond Physical Status.Neurocritical care · 2024Article
Corrections and comments
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Authors and funding
68 authors at 20 institutions in 2 countries.
Funding
Abstract
Importance: The association of surgical hematoma evacuation with clinical outcomes in patients with cerebellar intracerebral hemorrhage (ICH) has not been established. Objective: To determine the association of surgical hematoma evacuation with clinical outcomes in cerebellar ICH. Design, Setting, and Participants: Individual participant data (IPD) meta-analysis of 4 observational ICH studies incorporating 6580 patients treated at 64 hospitals across the United States and Germany (2006-2015). Exposure: Surgical hematoma evacuation vs conservative treatment. Main Outcomes and Measures: The primary outcome was functional disability evaluated by the modified Rankin Scale ([mRS] score range: 0, no functional deficit to 6, death) at 3 months; favorable (mRS, 0-3) vs unfavorable (mRS, 4-6). Secondary outcomes included survival at 3 months and at 12 months. Analyses included propensity score matching and covariate adjustment, and predicted probabilities were used to identify treatment-related cutoff values for cerebellar ICH. Results: Among 578 patients with cerebellar ICH, propensity score-matched groups included 152 patients with surgical hematoma evacuation vs 152 patients with conservative treatment (age, 68.9 vs 69.2 years; men, 55.9% vs 51.3%; prior anticoagulation, 60.5% vs 63.8%; and median ICH volume, 20.5 cm3 vs 18.8 cm3). After adjustment, surgical hematoma evacuation vs conservative treatment was not significantly associated with likelihood of better functional disability at 3 months (30.9% vs 35.5%; adjusted odds ratio [AOR], 0.94 [95% CI, 0.81 to 1.09], P = .43; adjusted risk difference [ARD], -3.7% [95% CI, -8.7% to 1.2%]) but was significantly associated with greater probability of survival at 3 months (78.3% vs 61.2%; AOR, 1.25 [95% CI, 1.07 to 1.45], P = .005; ARD, 18.5% [95% CI, 13.8% to 23.2%]) and at 12 months (71.7% vs 57.2%; AOR, 1.21 [95% CI, 1.03 to 1.42], P = .02; ARD, 17.0% [95% CI, 11.5% to 22.6%]). A volume range of 12 to 15 cm3 was identified; below this level, surgical hematoma evacuation was associated with lower likelihood of favorable functional outcome (volume ≤12 cm3, 30.6% vs 62.3% [P = .003]; ARD, -34.7% [-38.8% to -30.6%]; P value for interaction, .01), and above, it was associated with greater likelihood of survival (volume ≥15 cm3, 74.5% vs 45.1% [P < .001]; ARD, 28.2% [95% CI, 24.6% to 31.8%]; P value for interaction, .02). Conclusions and Relevance: Among patients with cerebellar ICH, surgical hematoma evacuation, compared with conservative treatment, was not associated with improved functional outcome. Given the null primary outcome, investigation is necessary to establish whether there are differing associations based on hematoma volume.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.