Risk Factors for Postoperative Hematoma Expansion after Craniotomy vs. Minimally Invasive Surgery for High-Altitude HICH

Background Exploring the prognosis of different surgical methods for hypertensive intracerebral hemorrhage (HICH) at high-altitude. Methods Patients were analyzed retrospectively in the CR and MI groups. Statistical analysis was conducted on the postoperative prognosis of two groups, and the risk factors for hematoma expansion were calculated separately. Logistic regression and ROC curve analysis were performed to determine the risk factors for hematoma expansion in both groups after surgery. Results Among the 373 patients with HICH, only 183 cases met the inclusion criteria for CR group, 190 cases for MI group. There were 17 cases of hematoma expansion in the CR group and 22 cases in the MI group. There was no significant difference in GOS score and survival curve between the CR and MI groups at discharge ( P  > 0.05). There was a significant difference in GOS score and survival curve between the CR and MI groups with and without hematoma expansion ( P  < 0.05). Regression analysis and ROC curve showed that low HC rate was a risk factor for hematoma expansion in the CR group. The high HC rate and the onset to surgery time are risk factors for hematoma expansion in the MI group. Conclusions The risk factors for postoperative hematoma expansion were low HC rate during surgery in the CR group, while in the MI group, the risk factors were high HC rate during surgery and short onset to surgery time.