What the hell are YOU doing to change the status quo of poor outcomes? I hate these lazy people that inform us of not getting to 100% recovery by basically throwing up their hands in defeat and saying; 'We have nothing for that problem.' Hope you are OK with such a fuckingly stupid answer when you are
A Secondary Analysis of MISTIE III
Abstract
Background and Purpose—
Trials
have shown potential clinical benefit for minimally invasive clot
evacuation of intracerebral hemorrhage (ICH). Prior research showing an
association between ICH size and functional outcome did not fully
address the spectrum of hematoma volumes seen after clot evacuation.
Methods—
In
this secondary analysis of the MISTIE III trial (Minimally Invasive
Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation III), we
included patients randomized to the surgical arm. The primary outcome
was good outcome (modified Rankin Scale score 0–3 at 1 year from study
enrollment). The primary predictors were the end-of-treatment (EoT) ICH
and intraventricular hemorrhage volumes and an end-of-treatment ICH
stratification scale called the EoT ICH volume score.
Results—
In
246 patients, the end-of-treatment computed tomography was performed an
average of 5 days from onset. For patients with good versus poor
outcomes, the mean end-of-treatment ICH and intraventricular hemorrhage
volumes were 12.9 versus 18.0 mL (P=0.002) and 0.5 versus 2.3 mL (P<0.001),
respectively. The probability of a good outcome decreased from 73% for
EoT ICH volume 3 (<5 mL) to 28% for EoT ICH volume 0 (>20 mL; P=0.001).
Conclusion
s—After
surgical clot evacuation, both ICH and intraventricular hemorrhage
volumes have a strong association with good neurological outcome. The
EoT ICH volume score needs independent verification, but such an
approach could be used for prognostication and therapeutic planning.
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