Abstract
The aim of this study was to delve into the relevant factors affecting hematoma evacuation (HE) rates during the treatment of sICH with stereotactic aspiration combined with catheter drainage. We pooled individual data from our prospective ICH databas, encompassing patients who underwent stereotactic aspiration and catheter drainage between July 2019 and July 2023. The primary outcome was HE rates prior to extubation, the secondary outcome was HE rates within 24 hours postoperatively. Logistic regression was employed to assess relevant clinical and radiological characteristics to establish a predictive model for achieving HE rates ≥ 70%. The model was validated by the ROC curve. Of the 894 patients with sICH enrolled in our database, 106 were eligible for this analysis. Factors affecting HE on the initial postoperative day were determined as preoperative hematoma volume (OR, 0.913; 95% CI, 0.836-0.997; P=0.042), blend sign (OR, 9.457; 95% CI, 0.999-89.508; P=0.050), and the catheter position score (OR, 5.551; 95% CI, 1.231-25.019; P=0.026). The positive blend sign (OR, 4.120; 95% CI, 1.344-12.630; P=0.013), absence of irregular hematoma morphology (OR, 0.291; 95% CI, 0.095-0.893; P=0.031), and hematoma edge not linked to the ventricle (OR, 0.185; 95% CI, 0.036-0.950; P=0.043) emerged as independent predictors for achieving HE rates ≥ 70% prior to extubation. Then, we developed two predictive models: one for early HE rates≥ 70%with a score from 0 to 7, and another for prior to extubation, scoring from 0 to 3. The ROC curve revealed AUC values of 0.871 and 0.753 for each model, respectively, and cutoff values of 5.5 and 1.5, accordingly. The predictive model of HE rates ≥ 70% within 24 hours postoperatively and prior to extuation has demonstrated remarkable predictive capability, holds the potential to assist clinicians in optimizing surgical efficiency.
Trial registration
ClinicalTrials.gov Identifier NCT03862729.