Effectiveness of Combined External Ventricular Drainage with Intraventricular Fibrinolysis for the Treatment of Intraventricular Haemorrhage with Acute Obstructive Hydrocephalus
| العنوان: | Effectiveness of Combined External Ventricular Drainage with Intraventricular Fibrinolysis for the Treatment of Intraventricular Haemorrhage with Acute Obstructive Hydrocephalus |
|---|---|
| المؤلفون: | Vinh Duc Nguyen, Chi Van Nguyen, Dai Quoc Khuong, Nam Trong Do, Trung Xuan Vuong, Hanh Thi My Pham, Dung Thi Pham, Thong Huu Tran, Dung Tien Nguyen, Tuan Anh Nguyen, Lieu Van Nguyen, Son N Do, Chinh Q Luong, Bai Xuan Nguyen, Anh Dat Nguyen, Lan Tuong Vu, Thomas Gaberel, Ton Duy Mai, Ngoc Duc Ngo, Thu Hong Be, Ha Viet Vu, Dat Nguyen, Hai Bui Hoang, Phuong Viet Dao, Binh Thanh Ngo, Ky Van Le, Hung Manh Ngo, Hung Duc Ngo, Quan Huu Nguyen |
| المصدر: | Cerebrovascular Diseases Extra, Vol 9, Iss 2, Pp 77-89 (2019) Cerebrovascular Diseases Extra |
| بيانات النشر: | S. Karger AG, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Acute obstructive hydrocephalus, Obstructive hydrocephalus, 030204 cardiovascular system & hematology, Lower risk, Risk Assessment, 03 medical and health sciences, Intraventricular fibrinolysis, 0302 clinical medicine, Fibrinolytic Agents, Risk Factors, Recombinant tissue plasminogen activator, Modified Rankin Scale, Humans, Medicine, Thrombolytic Therapy, Prospective Studies, Prospective cohort study, Aged, Cerebral Intraventricular Hemorrhage, Original Paper, External ventricular drainage, business.industry, Mortality rate, Ventricular drainage, Intraventricular haemorrhage, Recovery of Function, Middle Aged, Combined Modality Therapy, Treatment Outcome, Intracerebral haemorrhage, Neurology, lcsh:RC666-701, Tissue Plasminogen Activator, Anesthesia, Acute Disease, Drainage, Female, Observational study, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery, Hydrocephalus |
| الوصف: | Background: Intraventricular haemorrhage (IVH) patients with acute obstructive hydrocephalus (AOH) who require external ventricular drainage (EVD) are at high risk for poor outcomes. Intraventricular fibrinolysis (IVF) with low-dose recombinant tissue plasminogen activator (rtPA) can be used to improve patient outcomes. Here, we evaluated the impact of IVF on the risk of death and the functional outcomes in IVH patients with AOH. Methods: This prospective cohort study included IVH patients with hypertensive intracranial haemorrhage complicated by AOH who required EVD. We evaluated the risk of death and the functional outcomes at 1 and 3 months, with a specific focus on the impact of combined EVD with IVF by low-dose rtPA. Results: Between November 30, 2011 and December 30, 2014, 80 patients were included. Forty-five patients were treated with EVD alone (EVD group) and 35 received IVF (EVD+IVF group). The 30- and 90-day mortality rates were lower in the EVD+IVF group than in the EVD group (42.2 vs. 11.4%, p = 0.003, and 62.2 vs. 20%, p < 0.001, respectively). The Graeb scores were significantly lower in the EVD+IVF group than in the EVD group (p ≤ 0.001) during the first 3 days and on day 7 after assignment. The 30-day good functional outcome (modified Rankin Scale [mRS] score 0–3) was also higher in the EVD+IVF group than in the EVD group (6.7 vs. 28.6%, p = 0.008). However, the 90-day good functional outcome (mRS score 0–3) did not significantly increase in the EVD+IVF group (30.8% in the EVD group vs. 51.6% in the EVD+IVF group, p = 0.112). Conclusions: In our prospective observational study, EVD+IVF was associated with a lower risk of death in IVH patients. EVD+IVF improved the chance of having a good functional outcome at 1 month; however, this result was no longer observed at 3 months. |
| تدمد: | 1664-5456 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c64b90f6b623390d49304555fa97fce1Test https://doi.org/10.1159/000501530Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c64b90f6b623390d49304555fa97fce1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16645456 |
|---|