Traditional craniotomy versus current minimally invasive surgery for spontaneous supratentorial intracerebral haemorrhage: A propensity-matched analysis

Table 1 Clinical characteristics and outcomes of patients who underwent surgery, n (%)

Characteristic	Surgical procedures		P value	χ²/Z/t value
	Minimally invasive	Craniotomy
Mean age (years)	61.78 ± 10.87	56.27 ± 11.58	0.604	5.735
Age (years)
< 59.5	124 (22.3)	130 (23.3)	< 0.001	18.834
> 59.5	203 (36.4)	100 (18.0)
Sex
Female	131 (23.5)	82 (14.7)	0.292	1.111
Male	196 (35.2)	148 (26.6)
Admission Glasgow Coma Scale score
≤ 8	102 (18.3)	144 (25.9)	< 0.001	54.043
> 8	225 (40.4)	86 (15.4)
Left/right side
Left	158 (28.4)	108 (19.4)	0.751	0.100
Right	169 (30.3)	122 (21.9)
Deep cerebral hemorrhage	255 (45.8)	155 (27.8)	0.005	7.796
Systolic blood pressure on admission (mm Hg)	172.86 ± 26.40	175.73 ± 31.06	0.062	1.175
Smoking	112 (20.1)	91 (16.3)	0.199	1.646
Alcohol abuse	72 (12.9)	65 (11.7)	0.092	2.837
Hypertension	224 (40.2)	156 (28.0)	0.866	0.028
Coronary atherosclerosis	40 (7.2)	19 (3.4)	0.134	2.249
Diabetes	28 (5.0)	29 (5.2)	0.121	2.406
High blood fat disease	2 (0.4)	3 (0.5)	0.394	0.853
Lower extremity vein thrombosis	45 (8.1)	59 (10.6)	< 0.001	12.572
Lung infection	285 (51.2)	208 (37.3)	0.232	1.427
Pulmonary embolism	9 (1.6)	16 (2.9)	0.018	5.567
Intracranial infection	7 (1.3)	5 (0.9)	0.979	0.001
Postoperative cerebral infarction	14 (2.5)	33 (5.9)	< 0.001	17.71
Lower extremity pneumatic compression therapy	316 (56.7)	216 (38.8)	0.126	2.336
Heparin-like drug	22 (3.9)	52 (9.3)	< 0.001	29.56
Rivaroxaban	13 (2.3)	19 (3.4)	0.032	4.579
Hematoma volume (mL)
First quartile (< 28)	120 (21.5)	13 (2.3)	< 0.001	104.237
Quarter 2 (28-42)	87 (15.6)	50 (9.0)
Quarter 3 (42-64)	77 (13.8)	69 (12.4)
Quarter 4 (≥ 64)	43 (7.7)	98 (17.6)
Hematoma clearance rate	92 (90, 94)	87 (84, 89)	< 0.001	10.151
Admission d-dimer levels (mg/L)	1.30 (0.74, 2.74)	1.19 (0.53, 2.93)	0.072	14.252
Postoperative d-dimer mean levels, mg/L	3.17 (1.58, 6.78)	2.73 (1.39, 5.58)	0.009	2.601
Outcome
Favorable outcome	69.4 (227/327)	54.8 (126/230)	< 0.001	12.462
Unfavorable outcome	100 (18.0)	104 (18.7)
Survival within 1 year
Live	236 (42.4)	132 (23.7)	< 0.001	13.157
Dead	91 (16.3)	98 (17.6)

Table 2 Logistical regression equation analysis of clinical characteristics and outcomes of patients undergoing spontaneous supratentorial cerebral haemorrhage surgery

Characteristic	Crude OR	95%CI	P value	Adjusted OR	95%CI	P value
Age (years)	2.128	1.510-3.000	< 0.001	4.183	2.366-7.395	< 0.001
Deep cerebral hemorrhage	0.584	0.399-0.853	0.005	2.926	1.615-5.300	< 0.001
Lower extremity vein thrombosis	0.462	0.300-0.712	< 0.001	0.803	0.330-1.951	0.628
Pulmonary embolism	2.642	1.146-6.088	0.023	0.266	0.053-1.331	0.107
Postoperative cerebral infarction	3.745	1.955-7.174	< 0.001	0.343	0.137-0.858	0.022
Admission Glasgow Coma Scale score	0.833	0.793-0.874	< 0.001	0.811	0.748-0.880	< 0.001
Hematoma volume, mL	1.024	1.018-1.030	< 0.001	1.016	1.009-1.024	< 0.001
Hematoma clearance rate	0.687	0.643-0.735	< 0.001	0.667	0.614-0.724	< 0.001
Postoperative d-dimer mean levels (mg/L)	0.918	0.864-0.975	0.005	0.829	0.746-0.921	0.001
Heparin-like drug	0.247	0.145-0.420	< 0.001	0.351	0.134-0.920	0.033
Rivaroxaban	0.46	0.222-0.951	0.036	2.236	0.665-7.521	0.193

Crude odds ratio (OR): Analysis of logistic regression equations without consideration of individual disturbances. Adjusted OR: Logistical regression modeling after adjusting for age, deep cerebral hemorrhage, lower extremity vein thrombosis, pulmonary embolism, cerebral infarction, admission Glasgow Coma Scale score, hematoma volume, hematoma clearance rate, mean postoperative d-dimer levels, heparin-like drug, and rivaroxaban. OR: Odds ratio.

Table 3 Association between surgical procedures and postoperative outcomes in patients with spontaneous supratentorial cerebral haemorrhage

Analysis	Outcome	P value	Survival within 1 year	P value
Crude1 OR	0.534	< 0.001	0.519	< 0.001
Crude1 95%CI	0.376-0.758		0.364-0.742
Adjusted1 OR	1.071	0.913	0.454	0.221
Adjusted1 95%CI	0.312-3.685		0.128-1.609
Crude2 PSM OR	0.582	0.144	0.573	0.139
Crude2 PSM 95%CI	0.281-1.204		0.274-1.199
Adjusted2 PSM OR	2.235	0.092	2.450	0.070
Adjusted2 PSM 95%CI	0.877-5.695		0.931-6.451

¹Crude: Logistic regression modeling.

¹Adjusted: Logistic regression modeling adjusted for age, deep cerebral hemorrhage, lower extremity vein thrombosis, pulmonary embolism, cerebral infarction, admission Glasgow Coma Scale (GCS) score, hematoma volume, hematoma clearance rate, postoperative d-dimer mean levels, heparin-like drug, rivaroxaban.

²Crude: Logistic regression modeling after using phenol-soluble modulin.

²Adjusted: Logistic regression modeling after using phenol-soluble modulin adjusted for age, deep cerebral hemorrhage, lower extremity vein thrombosis, pulmonary embolism, postoperative cerebral infarction, admission GCS score, hematoma volume, hematoma clearance rate, postoperative d-dimer mean levels, heparin-like drug, rivaroxaban.

PSM: Phenol-soluble modulin; OR: Odds ratio.

Table 4 Clinical characteristics and outcome of patients undergoing spontaneous supratentorial cerebral haemorrhage surgery after propensity system matching, n (%)

Characteristic	Surgical procedures		P value	χ²/Z/t value
	Minimally invasive	Craniotomy
Mean age (years)	58.81 ± 10.848	59.01 ± 10.044	0.909	0.115
Age (years)
< 59.5	37 (27.2)	34 (25.0)	0.607	0.265
> 59.5	31 (22.8)	34 (25.0)
Sex
Female	35 (25.7)	30 (22.1)	0.391	0.737
Male	33 (24.3)	38 (27.9)
Admission Glasgow Coma Scale score
≤ 8	29 (21.3)	28 (20.6)	0.862	0.03
> 8	39 (28.7)	40 (29.4)
Left/Right side
Left	28 (20.6)	28 (20.6)	> 0.999	0
Right	40 (29.4)	40 (29.4)
Deep cerebral hemorrhage	45 (33.1)	43 (31.6)	0.720	0.129
Systolic blood pressure on admission (mm Hg)	172.9 ± 27.98	171.16 ± 35.59	0.750	0.319
Smoking	23 (16.9)	19 (14.0)	0.458	0.551
Alcohol abuse	14 (10.3)	14 (10.3)	> 0.999	0
Hypertension	45 (33.1)	46 (33.8)	0.855	0.033
Coronary atherosclerosis	8 (5.9)	8 (5.9)	> 0.999	0
Diabetes	9 (6.6)	7 (5.1)	0.595	0.283
High blood fat disease	0 (0.0)	0 (0.0)	> 0.999	0
Lower extremity vein thrombosis	12 (8.8)	15 (11.0)	0.519	0.416
Lung infection	60 (44.1)	58 (42.6)	0.613	0.256
Pulmonary embolism	1 (0.7)	1 (0.7)	> 0.999	0
Intracranial infection	1 (0.7)	0 (0.0)	0.317	1
Postoperative cerebral infarction	6 (4.4)	8 (5.9)	0.573	0.319
Lower extremity pneumatic compression therapy	66 (48.5)	64 (47.1)	0.405	0.832
Heparin-like drug	9 (6.6)	9 (6.6)	> 0.999	0
Rivaroxaban	5 (3.7)	5 (3.7)	> 0.999	0
Hematoma volume, mL
First quartile (< 28)	17 (12.5)	6 (4.4)	0.095	6.376
Quarter 2 (28-42)	19 (14.0)	24 (17.6)
Quarter 3 (42-64)	18 (13.2)	22 (16.2)
Quarter 4 (≥ 64)	14 (10.3)	16 (11.8)
Hematoma clearance rate	89 (88, 92)	89 (87, 91)	0.519	0.645
Admission D-dimer levels (mg/L)	1.2 (0.65, 2.52)	1.02 (0.48, 2.76)	0.318	0.999
Postoperative D-dimer mean levels (mg/L)	2.57 (1.33, 5.68)	2.48 (1.38, 5.03)	0.606	0.516
Outcome
Favorable outcome	50 (36.8)	42 (30.9)	0.143	2.15
Unfavorable outcome	18 (13.2)	26 (19.1)
Survival within 1 year
Live	51 (37.5)	43 (31.6)	0.138	2.205
Dead	17 (12.5)	25 (18.4)