Abstract Details

Title Predictors and Associated Outcomes with Unanticipated Surgical Evacuation in Patients with Intracerebral Hemorrhage: Post Hoc Analysis of ATACH 2 Trial

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-032

Objective Unanticipated surgical evacuation are associated with high rates of death or disability.

Background We performed this analysis to identify the rates, predictors and associated outcomes of unexpected neurosurgical intervention in a multicenter clinical trial, Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH)-2, involving good grade patients with intracerebral hemorrhage (ICH).

Design/Methods The ATACH 2 Trial determined the relative efficacy of intensive versus standard antihypertensive treatment in subjects with spontaneous supratentorial ICHs with a Glasgow Coma Scale (GCS) score of ³5 and intraparenchymal hematoma volume of< 60 cm3 on initial computed tomographic (CT) scan in whom surgical evacuation was not anticipated. We performed logistic regression analyses to determine the effect of unanticipated surgical intervention on death or disability at 3 months, death within 3 months, after adjusting for age and initial hematoma volume presence of intraventricular hemorrhage, and initial GCS score strata (14-15,9-13,8 or less).

Results Among the 992 subjects analyzed, 44 (4.4%) subjects required unanticipated surgical evacuation of hematoma. The mean time interval between randomization and surgical intervention was 1.6 days (±SD 3.7 days). In multivariate analyses, subjects who underwent unanticipated surgical evacuation had a significant higher risk of death or disability (OR 3.6, 95% confidence interval [CI] 1.6 – 8.3; p-value .002) at 3 months and mortality (OR 2.9, 95% CI 1.1 – 7.6; p-value .03) within 3 months after adjusting for potential confounders.

Conclusions In the large cohort of ATACH-2 subjects with good grade ICH, the rates of unanticipated surgical evacuation were low and associated with high rates of death or disability at 3 months.

Authors/Disclosures
Hamza I. Maqsood, MD (Dept of Neurology) PRESENTER	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Omar Saeed, MD	Dr. Saeed has nothing to disclose.
Mushtaq H. Qureshi, MD	No disclosure on file

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