Early treatment and prognosis in patients with traumatic cerebral hemorrhage

ZHOU Xiaolong; ZHANG Peng; WEI Wei

Abstract：Objective The effect of early surgery and initial conservative treatnent was compared for the prognosis of patients with traumatic intraparenchymal hemorrhage.Methods The cases of traumatic brain injury within 48 h in the hospital were collected and randomly assigned into early surgery group (hematoma evacuation within 12 h of randomization) and initial conservative treatment (subsequent evacuation allowed if deemed necessary).Patients were eligible when no more than two intraparenchymal hemorrhages over 10 mL and no extradural or subdural hematoma occurred.The primary outcome was evaluated by Glasgow outcome scale (COS)obtained by questionnaires within 6 months.The quality of life of patients was performed by European Quality of Life5 Dimensions (EQ-5D) questionnaires at 6 months.Results In fifty-eight patients randomized to early surgery with complete follow-up,34 (75.6％) had a favorable outcome,which was better than that of initial conservative treatment group (29,50.0％) (OR:0.43;95％ CI:0.21 ～0.88;P =0.02).There were significantly more death cases in the first 6 months in the initial conservative treatment group [21 (36.2％):7 (15.6％),P =0.0231].The level of quality of life at 6 months in two groups were not significantly different.Conclusion Early surgical treatment for the patients with traumatic parenchymal hemorrhage may lead to a better prognosis.