Survival outcomes after intracranial hemorrhage in liver disease

Carlito Lagman, Daniel T. Nagasawa, Daniel Azzam, John P. Sheppard, Cheng Hao Jacky Chen, Vera Ong, Thien Nguyen, Giyarpuram N. Prashant, Tianyi Niu, Alexander M. Tucker, Won Kim, Fady M. Kaldas, Nader Pouratian, Ronald W. Busuttil, Isaac Yang

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Survival outcomes for patients with liver disease who suffer an intracranial hemorrhage (ICH) have not been thoroughly investigated. OBJECTIVE: To understand survival outcomes for 3 groups: (1) patients with an admission diagnosis of liver disease (end-stage liver disease [ESLD] or non-ESLD) who developed an ICH in the hospital, (2) patients with ESLD who undergo either operative vs nonoperative management, and (3) patients with ESLD on the liver transplant waitlist who developed an ICH in the hospital. METHODS: We retrospectively reviewed hospital charts from March 2006 through February 2017 of patients with liver disease and an ICH evaluated by the neurosurgery service at a single academic medical center. The primary outcome was survival. RESULTS: We included a total of 53 patients in this study. The overall survival for patients with an admission diagnosis of liver disease who developed an ICH (n = 29, 55%) in the hospital was 22%. Of those patients with an admission diagnosis of liver disease, 27 patients also had ESLD. Kaplan–Meier analysis found no significant difference in survival for ESLD patients (n = 33, 62%) according to operative status. There were 11 ESLD patients on the liver transplant waitlist. The overall survival for patients with ESLD on the liver transplant waitlist who suffered an in-hospital ICH (n = 7, 13%) was 14%. CONCLUSION: ICH in the setting of liver disease carries a grave prognosis. Also, a survival advantage for surgical hematoma evacuation in ESLD patients is not clear.

Original languageEnglish (US)
Pages (from-to)138-146
Number of pages9
JournalOperative Neurosurgery
Volume16
Issue number2
DOIs
StatePublished - Feb 1 2019
Externally publishedYes

Keywords

  • Intracranial hemorrhages
  • Liver diseases
  • Subarachnoid hemorrhage
  • Subdural hematoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Survival outcomes after intracranial hemorrhage in liver disease'. Together they form a unique fingerprint.

Cite this