Predictive Factors for Clinical Outcomes Following Surgical Treatment in Patients with Spontaneous Intracerebral Hemorrhage at Krabi Hospital

Abstract

Background: Spontaneous Intracerebral Hemorrhage (sICH) is a critical neurosurgical emergency characterized by a high mortality rate. Krabi Hospital manages approximately 150-200 surgical cases annually, representing a significant disease burden. However, data regarding postoperative predictive factors within this specific hospital context remain limited. Identifying specific predictors is, therefore, essential for guiding personalized treatment planning and enhancing the efficiency of local patient care.

Objective: This study aimed to analyze predictive factors associated with clinical recovery and survival among patients undergoing surgery for spontaneous intracerebral hemorrhage at Krabi Hospital.

Methods: A retrospective analytic study was conducted by reviewing the medical records of patients diagnosed with sICH who underwent surgical intervention at Krabi Hospital between January 2022 and June 2025. A total of 275 eligible patients with complete records were selected using a total enumeration sampling method. Research instruments included a demographic and clinical outcome recording form and the Modified Rankin Scale (mRS) for assessing clinical recovery. Data were analyzed using multiple binary logistic regressions.

Results: The results revealed that the Glasgow Coma Scale (GCS) score was a significant predictor of survival; patients with higher GCS scores demonstrated a reduced likelihood of mortality (Adjusted OR = 0.691, 95% CI: 0.607-0.788, p < .001). Additionally, GCS was a significant predictor of clinical recovery; each one-point increase in the GCS score reduced the risk of poor recovery by approximately 87% (Adjusted OR = 0.130, 95% CI: 0.052-0.326). Hematoma volume was identified as a risk factor; every 1 ml increase in volume increased the risk of mortality by 1.136 times (95% CI: 1.045-1.235, p = .003) and the risk of poor recovery by 1.12 times or 11.8% (Adjusted OR = 1.118, 95% CI: 1.026-1.218, p = .011). Intraventricular hemorrhage (IVH) was a highly influential factor; patients with IVH had a 5.91-fold higher risk of mortality (Inverted Adjusted OR = 5.91, 95% CI: 2.39–14.70, p < .001) and a 4.90-fold higher risk of poor recovery (Inverted Adjusted OR = 4.90, 95% CI: 1.14–21.28) compared to those without IVH.

Conclusion: The GCS score, hematoma volume, and the presence of intraventricular hemorrhage (IVH) were identified as significant predictors of postoperative survival and clinical recovery in patients with spontaneous intracerebral hemorrhage.