Abstract Details

Title Early Removal of Spontaneous Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P4 - Poster Session 4 (5:00 PM-6:00 PM)

Poster/Presentation
Number 13-020

Objective

The preferred approach for treating spontaneous intracerebral hemorrhage remains unclear, either early surgery or a conservative treatment. Hence, we sought to compare these treatment methods in this population.

Background The aim is to analyze the prognosis of patients with superficial lobar intracerebral hemorrhage and spontaneous supratentorial intracerebral hemorrhage when undergoing early surgery or conservative treatment.

Design/Methods

Medline, Cochrane, and Embase databases were systematically searched until 25 September 2024 for Randomized Controlled Trials comparing early surgery and conservative treatment to remove hematoma caused by spontaneous supratentorial intracerebral hemorrhages. Data were examined using the Mantel-Haenszel method and 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics. RStudio, version 4.3.2, was used for statistical analysis.

Results A total of 3 randomized controlled trials and 1934 patients were included, of whom 960 (49,6%) underwent early surgery for the removal of the hematoma caused by spontaneous supratentorial intracerebral hemorrhage and 974 (50,4%) received the conservative treatment. Compared with the conservative treatment group, the early surgery group achieved better rates of favorable prognosis based on the modified Rankin scale at 180 days (40% vs 35%; OR 1.25; 95%CI 1.03-1.51; P= 0.024620; I²= 0%). Mortality (27% vs 32%; OR 0.66; 95%CI 0.39-1.12; P= 0.123310; I²= 78%) and favorable or unfavorable prognosis based on the Extended Glasgow Outcome Scale (GOSE) at 180 days (32% vs 29%; OR 1.15; 95%CI 0.92-1.43; P= 0.221678; I²= 0%) and (68% vs 71%; RR 0.96; 95%CI 0.91-1.03; P= 0.270196; I²= 0%), respectively, did not reach a statistically significant difference between groups.

Conclusions

In this meta-analysis, consistent results suggest that early surgery is associated with better rates of favorable prognosis, based on the modified Rankin scale at 180 days, than initial conservative treatment in patients with supratentorial intracerebral hemorrhage.

Authors/Disclosures
Samuel Luca R. Pinheiro PRESENTER	Mr. Pinheiro has nothing to disclose.
Rubia B. Sousa, Medical studant	Mrs. Sousa has nothing to disclose.
Livia F. De Lima, student	Miss DE LIMA has nothing to disclose.
Catarina A. Lima	Miss Lima has nothing to disclose.
Maria Luiza C. Pessoa, Student	Miss Pessoa has nothing to disclose.
Ana L. Carvalho	No disclosure on file
María J. Santacruz Villalba, MD	Dr. Santacruz Villalba has nothing to disclose.
Manuela R. Queiroz	No disclosure on file
Luana I. Carvalho	No disclosure on file
Luca C. Augusto, Sr., MBBS	Mr. Augusto has nothing to disclose.
Artur Menegaz de Almeida, MS	Mr. Menegaz de Almeida has nothing to disclose.
Luis Sobreira, MS	Mr. Sobreira has nothing to disclose.

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