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. 2022 Oct 13:9:949804.
doi: 10.3389/fsurg.2022.949804. eCollection 2022.

Association between minimally invasive surgery and late seizures in patients with intracerebral hemorrhage: A propensity score matching study

Jiahe Lin  1 , Ru Lin  2 , Xianxian Li  1 , Jiahe Ye  1 , Yuchen Wang  3 , Beining Zhang  3 , Xinling Chen  3 , Xinshi Wang  4 , Shanshan Huang  1 , Suiqiang Zhu  1
Affiliations

Association between minimally invasive surgery and late seizures in patients with intracerebral hemorrhage: A propensity score matching study

Jiahe Lin et al. Front Surg. .

Abstract

Purpose: The association between minimally invasive surgery (MIS) for hematoma evacuation and late seizures after intracerebral hemorrhage (ICH) remains uncertain. We aimed to investigate whether MIS increases the risk of late seizures after ICH and identify the risk factors for late seizures in this patient subgroup.

Methods: We retrospectively included consecutive inpatients diagnosed with ICH at two tertiary hospitals in China. The subjects were divided into the MIS group (ICH patients who received MIS including hematoma aspiration and thrombolysis) and conservative treatment group (ICH patients who received conservative medication). Propensity score matching was performed to balance possible risk factors for late seizures between the MIS and conservative treatment groups. Before and after matching, between-group comparisons of the incidence of late seizures were performed between the MIS and conservative treatment groups. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for late seizures in MIS-treated patients.

Results: A total of 241 and 1,689 patients were eligible for the MIS and conservative treatment groups, respectively. After matching, 161 ICH patients from the MIS group were successfully matched with 161 ICH patients from the conservative treatment group (1:1). Significant differences (p < 0.001) were found between the MIS group (31/241, 12.9%) and conservative treatment group (69/1689, 4.1%) in the incidence of late seizures before matching. However, after matching, no significant differences (p = 0.854) were found between the MIS group (17/161, 10.6%) and conservative treatment group (16/161, 9.9%). Multivariate logistic regression analysis revealed that cortical involvement (OR = 2.547; 95% CI = 1.137-5.705; p value = 0.023) and higher National Institutes of Health Stroke Scale (NIHSS) scores (OR = 1.050; 95% CI = 1.008-1.094; p value = 0.019) were independent risk factors for late seizures.

Conclusion: Our study revealed that receiving MIS did not increase the incidence of late seizures after ICH. Additionally, cortical involvement and NIHSS scores were independent risk factors for late seizures in MIS-treated patients.

Keywords: intracerebral hemorrhage; minimally invasive surgery; propensity score matching; risk factor; seizures.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of patient inclusion and exclusion. ICH = intracerebral hemorrhage; MIS = minimally invasive surgery; TJH = Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; WZH = the First Affiliated Hospital of Wenzhou Medical University.
Figure 2
Figure 2
Comparison of the late seizure rates between the MIS and conservative treatment groups. MIS = minimally invasive surgery; *** = p value < 0.001; ns = nonsignificance.
See this image and copyright information in PMC

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References

    1. Krishnamurthi RV, Feigin VL, Forouzanfar MH, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of first-ever ischaemic and haemorrhagic stroke during 1990–2010: findings from the global burden of disease study 2010. Lancet Glob Health. (2013) 1(5):e259–81. 10.1016/S2214-109X(13)70089-5 - DOI - PMC - PubMed
    1. Poon MT, Fonville AF, Al-Shahi Salman R. Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. (2014) 85(6):660–7. 10.1136/jnnp-2013-306476 - DOI - PubMed
    1. Vitt JR, Sun CH, Le Roux PD, Hemphill JC, 3rd., Minimally invasive surgery for intracerebral hemorrhage. Curr Opin Crit Care. (2020) 26(2):129–36. 10.1097/MCC.0000000000000695 - DOI - PubMed
    1. Zazulia AR, Diringer MN, Derdeyn CP, Powers WJ. Progression of mass effect after intracerebral hemorrhage. Stroke. (1999) 30(6):1167–73. 10.1161/01.STR.30.6.1167 - DOI - PubMed
    1. Mendelow AD, Gregson BA, Fernandes HM, Murray GD, Teasdale GM, Hope DT, et al. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial intracerebral haematomas in the international surgical trial in intracerebral haemorrhage (STICH): a randomised trial. Lancet. (2005) 365(9457):387–97. 10.1016/S0140-6736(05)70233-6 - DOI - PubMed

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