Evidence map›Paper›PMID 37770798›Full record

Observational studyActa neurochirurgica2023

Closure intracranial pressure as a determinant of surgical decompression adequacy in spontaneous supratentorial intracerebral haematoma: a multicentre observational study.

Jia Xu Lim, Nivedh Dinesh, Jiani Sherry Liu, Rambert Wee, Sukit Shu Kiat Chan, Julian Xinguang Han, Min Wei Chen

Abstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Jia Xu LimDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore. jiaxu.lim@mohh.com.sg.
Nivedh DineshDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
Jiani Sherry LiuDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
Rambert WeeDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
Sukit Shu Kiat ChanDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
Julian Xinguang HanDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
Min Wei ChenDepartment of Neurosurgery, National Neuroscience Institute, Singapore, Singapore, Singapore.
National Neuroscience Institute · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite significant advances, the literature on the optimal surgical treatment for spontaneous supratentorial intracerebral haematoma (ICH) remains lacking. Intraoperative ICP measured on closure (closure ICP) was reported to be a potential marker of adequate decompression in various neurosurgical conditions. We hypothesize that closure ICP also correlates with outcomes in ICH.

methodsA multicentre retrospective study of 203 decompressive surgeries performed for ICHs was conducted (clot evacuation with either craniectomy or craniotomy). Receiver operating characteristic analysis on closure ICP was performed and an optimal threshold of 5 separated the patients into inadequate (iICP; ICP > 5 mmHg) and good decompression (gICP; ICP ≤ 5 mmHg). Postoperative ICP control, modified Rankin scale (mRS) and mortality were reported.

resultsThere were 85 patients in the iICP and 118 patients in the gICP group respectively. The mean age, median preoperative Glasgow coma scale, ICH laterality, location, and volume were similar. After multivariable analysis, the need for (OR 2.55 [1.31-4.97]) and the duration of postoperative hyperosmolar therapy (iICP: 3 days, gICP: 1 day; p = 0.045), and repeat surgery for refractory ICP (OR 5.80 [1.53-22]) were more likely in the iICP group. The likelihood of mRS improvement at 1-year follow up was significantly worse in the iICP group (OR 0.38 [0.17-0.83], p = 0.015).

conclusionClosure ICP is an objective and reproducible surgical target. When planning for surgical decompression, obtaining closure ICP of ≤ 5 mmHg is potentially able to improve postoperative ICP management and optimise functional recovery in a well selected patient population.

Indexed as

Cerebral HemorrhageIntracranial PressureDecompression, SurgicalGlasgow Coma ScaleHematomaHumansRetrospective StudiesTreatment OutcomeDecompressionFunctionIntracranial pressureOutcomesSpontaneous intracerebral haematomaStroke

Identifiers

PMID37770798
OpenAlexW4387124432

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Registered trials

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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.