PT -期刊文章盟亚b Abulhasan AU -珍妮分类盟节日Al-Ramadhani DABR-NR盟——凯瑟琳·t·莫里森AStat盟——马克。r角TI -功能结果和死亡率在密集的医疗和手术后颅内出血患者支持援助- 10.1212 / WNL。0000000000207132 DP - 2023年3月16日TA -神经病半岛投注体育官网学PG - 10.1212 / WNL。0000000000207132 4099 - http://n.半岛投注体育官网neurology.org/content/early/2023/03/15/WNL.0000000000207132.short 4100 - //www.ebmtp.com/content/early/2023/03/15/WNL.0000000000207132.full AB -背景和目的:尽管几十年的日益复杂的neurocritical护理,患者自发性脑出血后的结果(我)仍然低迷。这是否反映了治疗虚无主义,或者主要损伤的影响已经受到了质疑。在这个当代队列中,我们确定了30 -和90天的死亡率、死因别死亡率、功能结果和手术治疗的效果在一个积极的医疗和手术支持的文化。方法:这是一个连续的回顾性队列研究成年患者自发我承认叔neurocritical病房。患者二次我和那些limitation-of-care之前72 -小时被排除在外。对于每一个我的分数,30 - 90天的死亡率,改良Rankin规模(夫人)检查。颅骨切开术的影响/颅骨切除术±血肿对幕上的的结果我决心使用倾向得分匹配。放电后的病人随访的中值为2.2(差,0.4 - -4.4)年。结果:319名患者自发我(平均年龄为69位差,60 - 77年,60%的男性),30 - 90天的死亡率分别为16%和22%,分别和不利的功能性结果夫人(4 - 6)是50%,平均3.1个月,此前我。住院死亡率的预测反映原我的分数。 Unfavorable outcomes for ICH score 3 and 4 were 73% and 86%, respectively. The most common adjudicated primary causes of mortality were direct effect or progression of the ICH (54%), refractory cerebral edema (21%), and medical complications (11%). In matched analyses, lifesaving surgery for supratentorial ICH did not significantly alter mortality or unfavorable functional outcome in patients overall. In subgroup analyses restricted to (1) surgery with hematoma evacuation, and (2) ICH score 3 and 4 patients, the odds of 30-day mortality were reduced by 71% (OR, 0.29, 95% CI, 0.09-0.9, p=0.032) and 80% (OR, 0.2, 95% CI, 0.04-0.91, p=0.038), respectively, but no difference was observed for 90-day mortality or unfavorable functional outcome.Discussion: This study demonstrates that poor outcomes after ICH prevail despite aggressive treatment. Unfavorable outcomes appear related to direct effects of the primary injury and not to premature care limitations. Lifesaving surgery for supratentorial lesions delayed mortality but did not alter functional outcomes.

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