Factors Affecting the Therapeutic Choices for Hypertensive Patients with Basal Ganglia Hemorrhage
Date Issued
2007
Date
2007
Author(s)
Ku, Shei-Ling
DOI
zh-TW
Abstract
Background:Hemorrhagic strokes are mostly caused by ruptures of cerebral vessels. The critical symptoms and signs as well as the quick loss of conscience may result in high mortality rate, the disease comes with severe ramifications of patients, family members and even the society concerning the inconvenience and liability. There have been few systemic studies and analysis for choosing alternative therapeutic approaches considering the individual patient condition and clinical presentation when patients are put under treatment.
Objective:This study aimed at studying the various factors affecting the alternative therapies decision making targeting the hypertensive basal ganglia bleeding patients with the individualized characteristics and clinical presentation.
Method:This study applied the retrospective chart review on a medical center located at Taipei from January 1 2003 to March 31 2006. Patients’ diagnosed as ICD-9-CM-431(intracerebral hemorrhage）were screened to select one hundred and ten individuals who had the hypertensive basal ganglia bleeding. These patients were put under analysis in the areas of age, gender, accompanied diseases, blood pressure upon arrival, GCS up on arrival, bleeding volume, the anatomical side of bleeding and admission conditions. The analysis was carried out with X2 ,T-Test, regression analysis to study the correlation of selecting alternative therapies.
Result:Forty nine patients were subject to surgical treatment and sixty one patients were subject to medical treatment. The bleeding volume(p=0.03) and GCS(p<0.001) upon arrival presented statistical difference; Regressions analysis showed patient population aged between 45 to 65 had 3.042 times adopting surgical approaches versus population over 65 years old(p=0.026). In surgical treatment group, the patient number with bleeding volume greater than 30 cc was 25.297 times versus those with less than 20 cc bleeding volume(p=0.018); the surgical treatment group patient number of on-arrival GCS ranged 9-12 with variation less or equal to 1 was 4.329 times versus those with on-arrival GCS greater or equal to 13 and variation less or equal to 1(P=0.011); the surgical treatment group patient number of on-arrival GCS ranged 9-12 with variation greater or equal to 2 was 7.415 times versus those with on-arrival GCS greater or equal to 13 and variation less or equal to 1(P=0.011); The surgical treatment group patient number of on-arrival GCS ranged 9-12 and variation greater or equal to 2 was 7.415 times versus those with on-arrival GCS greater or equal to 13 and variation less or equal to 1(p=0.015); The surgical treatment group patient number of on-arrival GCS greater or equal to 13 and variation greater or equal to 2 was 6.275 times versus those with on-arrival GCS greater or equal to 13 and variation less or equal to 1(p=0.041)
Conclusion:This study demonstrated the physicians in the subject hospital adopted patient age, on-arrival GCS, bleeding volume ,GCS severity score(9-12 and 13 or greater) and patients’ condition after admission to select alternative therapeutic approaches for hypertensive basal ganglia bleeding patients.
Subjects
外科治療
內科治療
Hypertensive Basal Ganglia Hemorrhage
Surgical Treatment
Medical Treatment
Type
thesis
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