Long Term Outcome after Hemorrhagic Stroke Surgery (LOMSS) in Hong Kong Chinese

Abstract

Introduction: The benefits of surgical treatment to reduce ischemic penumbra and raised intracranial pressure have been challenged by results of randomized controlled clinical trial. With the lack of level I evidence, decision of whether to evacuate spontaneous intracerebral hematoma (ICH) surgically would be based on discussion with patients and families regarding long term surgical outcome. Aim: We aimed to assess the long-term functional and cognitive outcome of ICH surgery in Hong Kong Chinese in Hong Kong, and to determine a simple prognostication scoring system for clinical application. Methods: The study was carried out retrospectively in a regional neurosurgical center in Hong Kong. We identified 191 patients with ICH surgery performed between January 1999 and December 2008. 152(80%) patients had long-term neurological outcome data available for analyses. The study was registered at ClinicalTrials.gov (NCT01409252). Results: Long-term favorable neurological outcome (mRS 0-3) was reported in 27%. Favorable neurological outcome negatively correlated with age, male sex, medical co-morbidities, and positively correlated with admission Glasgow Coma Scale. Long-term favorable cognitive outcome was negatively correlated with age. Conclusion: In ICH patients, functional outcome was influenced by age, admission GCS, medical co-morbidities, and male gender, but cognitive outcome was independently associated with age alone.