Author:
Ho Ue-Cheung,Hsieh Chia-Jung,Lu Hsueh-Yi,Huang Abel Po-Hao,Kuo Lu-Ting
Abstract
Abstract
Background
Spontaneous intracerebral hemorrhage (ICH) is a condition associated with high mortality and morbidity. Survivors may require prolonged intubation with mechanical ventilation (MV). The aim of this study was to analyze the predictors of extubation failure and prolonged MV in patients who undergo surgical evacuation.
Methods
This retrospective study was conducted on adult patients with ICH who underwent MV for at least 48 h and survived > 14 days after surgery. The demographics, clinical characteristics, laboratory tests, and Glasgow Coma Scale score were analyzed.
Results
A total of 134 patients with ICH were included in the study. The average age of the patients was 60.34 ± 15.59 years, and 79.9% (n = 107) were extubated after satisfying the weaning parameters. Extubation failure occurred in 11.2% (n = 12) and prolonged MV in 48.5% (n = 65) patients. Multivariable regression analysis revealed that a white blood cell count > 10,000/mm3 at the time of extubation was an independent predictor of reintubation. Meanwhile, age and initial Glasgow Coma Scale scores were predictors of prolonged MV.
Conclusions
This study provided the first comprehensive characterization and analysis of the predictors of extubation failure and prolonged MV in patients with ICH after surgery. Knowledge of potential predictors is essential to improve the strategies for early initiation of adequate treatment and prognosis assessment in the early stages of the disease.
Publisher
Springer Science and Business Media LLC
Reference54 articles.
1. Akers A, Al-Shahi Salman R, Awad A, Dahlem I, Flemming K, Hart K. Synopsis of guidelines for the clinical management of cerebral cavernous malformations: consensus recommendations based on systematic literature review by the Angioma Alliance Scientific Advisory Board clinical experts panel. Neurosurgery. 2017;80:665–80. https://doi.org/10.1093/neuros/nyx091.
2. Caceres JA, Goldstein JN. Intracranial Hemorrhage. Emerg Med Clin North Am. 2012;30:771–94. https://doi.org/10.1016/j.emc.2012.06.003.
3. Feigin VL, Lawes CM, Bennett DA, Barker-Collo SL, Parag V. Worldwide Stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurol. 2009;8:355–69. https://doi.org/10.1016/S1474-4422(09)70025-0.
4. Rost NS, Smith EE, Chang Y, Snider RW, Chanderraj R, Schwab K, et al. Prediction of functional outcome in patients with primary intracerebral Hemorrhage: the FUNC score. Stroke. 2008;39:2304–9. https://doi.org/10.1161/STROKEAHA.107.512202.
5. Rathor MY, Rani MF, Jamalludin AR, Amran M, Shahrin TC, Shah A. Prediction of functional outcome in patients with primary intracerebral Hemorrhage by clinical-computed tomographic correlations. J Res Med Sci. 2012;17:1056–62.