• Johan Jakobsson, Henrietta Nittby Redebrandt, Lovisa Tobieson, Jiri Bartek, Andreas Bartley, Ebba Troberg, Sadia Mirza, Parmenion P Tsitsopoulos, Niklas Marklund, and Andreas Fahlström.
• Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
• World Neurosurg. 2023 Feb 1; 170: e351e363e351-e363.

ObjectiveTo investigate long-term survival, neurologic outcome, and quality of life in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) treated with craniotomy and hematoma evacuation.MethodsA nationwide multicenter retrospective analysis of 341 patients who underwent craniotomy and evacuation of supratentorial ICH between January 1, 2011, and December 31, 2015, was performed. Baseline characteristics associated with 6-month mortality and long-term mortality were investigated. Survivors received a questionnaire about their state of health from which EuroQol 5D (EQ-5D) and modified Rankin scale (mRS) were obtained. Predictors of mortality, unfavorable outcome, and life quality were analyzed.ResultsThe mean follow-up time was 55.2 months. Predictors of 6-month mortality in multiple regression analysis were age ≥75 years, previous myocardial infarction, lower level of consciousness, and mechanical ventilation. Predictors of long-term mortality were higher age and mechanical ventilation. At follow-up, 49.5% of survivors had a favorable neurologic outcome (mRS ≤3). Predictors of an unfavorable functional outcome were higher age and ICH volume ≥50 mL. The mean EQ-5D health index was 0.719, and the mean EQ-5D visual analog scale score was 53.9. In multiple regression, only a higher mRS score was significantly associated with worse life quality.ConclusionsKnowledge about survival, functional outcome, and life quality as well as their predictors in this specific patient group is previously primarily described in short-term follow-up. This multicenter study provides novel information in the long-term perspective, which is important for improved surgical decision-making and prognostication.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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