The prognostic scale of postoperative lethality at patients suffered from hypertensive intracerebral hemorrhages

Objective: to create the patent prognostic scale of postoperative lethality at patients suffered from hypertensive intracerebral hemorrhages and to estimate the indications and the volume of surgical intervention depending on the risk degree based on developed prognostic scale. Material and methods: The retrospective analysis of postoperative lethality among 336 patients with hypertensive intracerebral hematomas treated at the base of neurosurgical department of Emergency Care Hospital in Ufa was conducted. The favorable outcome was observed at 187 patients (1st group) while 149 patients died in different postoperative periods (2d group). The analysis of surgical treatment outcomes was performed with the usage of patent scale developed at the base of using the principle of aggregate estimation (by the sum of gathered scores). The statistical examination was performed using Kul’ban method. The significance value compiled р< 0,001 and р< 0,0001. The follow-up postoperative period was 30 days. Results and discussion: The lethality rate was analyzed depending on the following parameters: age, the level of consciousness impairment, volume and localization of hemorrhage, presence of ventricular hemorrhage. The examination analysis of influence power of various parameters on the outcomes of intracranial hemorrhage revealed the following dependence: the most informative parameter was the level of consciousness with the gradual decreasing of informative value from the degree of ventricular hemorrhage, then - volume of hematoma; localization of hematoma and patient’s age. The average sum of scores in the group of survived patients was 6,45 scores comparing with 10,25 scores in the group of died patients. The lethality dynamics depending on the sum of gathered scores showed the directly proportional increase of unfavorable outcomes number with increase of estimated figures by our patent scale. We distinguished 4 degrees of surgical risk depending on the lethality rate. The relationships between every criteria group and type of operation was determined using the revelation of connection between simple comparison of scores increase and lethality rate. Conclusion: The data analysis based on patent prognostic scale of postoperative lethality allows determing the criteria for prognosis of surgical treatment outcomes. The assignment of the risk degrees based on the suggested scale will allow choosing the optimal type and volume of surgical interventions at patients with hypertension hemorrhages.

геморрагический инсульт, эндоскопическое удаление гематом, прогноз летальности, интравентрикулярное кровоизлияние, hemorrhagic stroke, endoscopic removal of hematoma, lethality prognosis, ventricular hemorrhage

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