Trends in surgical procedures for spontaneous intracerebral hemorrhage in Japan

Shigeyuki Tahara; Yujiro Hattori; Shotaro Aso; Kazuaki Uda; Ryosuke Kumazawa; Hiroki Matsui; Kiyohide Fushimi; Hideo Yasunaga; Akio Morita

doi:10.1016/j.jstrokecerebrovasdis.2022.106664

Trends in surgical procedures for spontaneous intracerebral hemorrhage in Japan

J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106664. doi: 10.1016/j.jstrokecerebrovasdis.2022.106664. Epub 2022 Jul 28.

Authors

Shigeyuki Tahara¹, Yujiro Hattori², Shotaro Aso³, Kazuaki Uda⁴, Ryosuke Kumazawa⁵, Hiroki Matsui⁵, Kiyohide Fushimi⁶, Hideo Yasunaga⁵, Akio Morita⁷

Affiliations

¹ Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. Electronic address: tabara@nms.ac.jp.
² Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan; Department of Anatomy and Neurobiology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
³ Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
⁴ Health Services Research and Development Center, University of Tsukuba, Ibaraki, Japan.
⁵ Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
⁶ Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
⁷ Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.

PMID: 35908346
DOI: 10.1016/j.jstrokecerebrovasdis.2022.106664

Abstract

Objectives: Minimally invasive surgery for spontaneous intracerebral hemorrhage (ICH) has become increasingly popular in recent years. However, there are no reports on the recent trends in surgical procedures for spontaneous ICH. To investigate current trends in surgical methods for spontaneous ICH using a nationwide inpatient database from Japan.

Materials and methods: Patients who underwent surgery for spontaneous ICH between April 2014 and March 2018 were identified in a nationwide inpatient database from Japan. We examined patient characteristics, diagnoses, types of surgery, complications, and discharge status.

Results: We identified 21,129 inpatients who underwent surgery for spontaneous ICH. The procedures were as follows: 16,256 (76.9%) transcranial hemorrhage evacuations, 3722 (17.6%) endoscopic hemorrhage evacuations, and 1151 (5.4%) stereotactic aspirations of hemorrhage. Patients tended to receive transcranial hemorrhage evacuations in hospitals with fewer surgical cases. The proportions of endoscopic hemorrhage evacuations increased annually, whereas those of stereotactic surgery decreased. The proportions of transcranial surgery remained almost unchanged. Tracheostomy and hospitalization costs were lower in the stereotactic aspirations of hemorrhage group, and the proportions of reoperation were higher in the endoscopic hemorrhage evacuations group.

Conclusions: The use of endoscopic surgery for spontaneous ICH has increased in Japan. This study can form the basis of future clinical investigations into spontaneous ICH surgery.

Keywords: Endoscopic surgery; Intracerebral hemorrhage; Nationwide inpatient database; Stereotactic surgery; Transcranial surgery.

MeSH terms

Cerebral Hemorrhage* / diagnostic imaging
Cerebral Hemorrhage* / surgery
Endoscopy / adverse effects
Humans
Japan
Minimally Invasive Surgical Procedures* / methods
Treatment Outcome