| アブストラクト | OBJECTIVES: To compare the prognosis of late elderly patients with spontaneous intracerebral hemorrhage (ICH) treated by endoscopic evacuation and craniotomy MATERIALS AND METHODS: Using the Diagnosis Procedure Combination database, we identified patients aged >/= 75 years who underwent surgery for spontaneous ICH within 48 hours after admission between April 2014 and March 2018. Eligible patients were classified into two groups according to the type of surgery (endoscopic surgery and craniotomy). Propensity-score matching weight analysis was conducted to compare the good neurological outcome modified Rankin Scale (mRS) score (0-4) at discharge as the primary endpoint between the two groups. Secondary endpoints were postoperative meningitis, tracheostomy, reoperation within 3 days and total hospitalization costs. RESULTS: Among the 5,396 eligible patients, endoscopic surgery and craniotomy were performed in 895 and 4,501 patients, respectively. In the propensity-score matching weight analysis, all covariates were well balanced. The proportions of patients with a good prognosis (mRS score at discharge: 0-4) did not significantly differ between the surgical procedures (42.1% vs. 42.8%, p = 0.828). The proportions of meningitis, tracheostomy and reoperation were not significantly different between the two groups. Hospitalization costs were significantly higher in the craniotomy group than in the endoscopic surgery group (25,536 vs. 29,603 US dollars, p = 0.012). CONCLUSIONS: Inhospital outcomes did not differ between endoscopic and open surgeries for spontaneous ICH in the late-stage elderly patients aged >/=75 years. Hospitalization costs were significantly higher in the craniotomy group, suggesting that endoscopic surgery may be more acceptable. |
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| ジャーナル名 | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association |
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| 投稿日 | 2023/9/8 |
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| 投稿者 | Tahara, Shigeyuki; Hattori, Yujiro; Aso, Shotaro; Uda, Kazuaki; Kumazawa, Ryosuke; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Morita, Akio |
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| 組織名 | Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical;School, Tokyo, Japan. Electronic address: tabara@nms.ac.jp.;School, Tokyo, Japan; Department of Anatomy and Neurobiology, Graduate School of;Medicine, Nippon Medical School, Tokyo, Japan. Electronic address:;yujiro@nms.ac.jp.;Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan. Electronic address: s_aso@m.u-tokyo.ac.jp.;Health Services Research and Development Center, University of Tsukuba, Ibaraki,;Japan. Electronic address: udakazuaki-tky@umin.ac.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan. Electronic address:;rkumazawa@m.u-tokyo.ac.jp.;ptmatsui-tky@umin.ac.jp.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan. Electronic address:;kfushimi.hci@tmd.ac.jp.;yasunagah@m.u-tokyo.ac.jp.;School, Tokyo, Japan. Electronic address: amor-tky@nms.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37677895/ |
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