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@article{1139386,
author = {Mendelow, David A and Gregson, Barbara A and Rowan, Elise N and Murray, Gordon D and Gholkar, Anil and Mitchell, Patrick M and Smrčka, Martin},
article_location = {NEW YORK},
article_number = {9890},
doi = {http://dx.doi.org/10.1016/S0140-6736(13)60986-1},
language = {eng},
issn = {0140-6736},
journal = {Lancet},
note = {Nepřevádět do RIV - prof. Smrčka uveden v the STICH II Investigators},
title = {Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial},
volume = {382},
year = {2013}
}
TY - JOUR
ID - 1139386
AU - Mendelow, David A - Gregson, Barbara A - Rowan, Elise N - Murray, Gordon D - Gholkar, Anil - Mitchell, Patrick M - Smrčka, Martin
PY - 2013
TI - Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial
JF - Lancet
VL - 382
IS - 9890
SP - 397-408
EP - 397-408
PB - ELSEVIER SCIENCE INC
SN - 01406736
N1 - Nepřevádět do RIV - prof. Smrčka uveden v the STICH II Investigators
N2 - Background: The balance of risk and benefit from early neurosurgical intervention for conscious patients with superficial lobar intracerebral haemorrhage of 10-100 mL and no intraventricular haemorrhage admitted within 48 h of ictus is unclear. We therefore tested the hypothesis that early surgery compared with initial conservative treatment could improve outcome in these patients. Methods: In this international, parallel-group trial undertaken in 78 centres in 27 countries, we compared early surgical haematoma evacuation within 12 h of randomisation plus medical treatment with initial medical treatment alone (later evacuation was allowed if judged necessary). An automatic telephone and internet-based randomisation service was used to assign patients to surgery and initial conservative treatment in a 1: 1 ratio. The trial was not masked. The primary outcome was a prognosis-based dichotomised (favourable or unfavourable) outcome of the 8 point Extended Glasgow Outcome Scale (GOSE) obtained by questionnaires posted to patients at 6 months. Analysis was by intention to treat. This trial is registered, number ISRCTN22153967. Findings: 307 of 601 patients were randomly assigned to early surgery and 294 to initial conservative treatment; 298 and 291 were followed up at 6 months, respectively; and 297 and 286 were included in the analysis, respectively. 174 (59%) of 297 patients in the early surgery group had an unfavourable outcome versus 178 (62%) of 286 patients in the initial conservative treatment group (absolute difference 3.7% [95% CI -4.3 to 11.6], odds ratio 0.86 [0.62 to 1.20]; p=0.367). Interpretation: The STICH II results confirm that early surgery does not increase the rate of death or disability at 6 months and might have a small but clinically relevant survival advantage for patients with spontaneous superficial intracerebral haemorrhage without intraventricular haemorrhage.
ER -
MENDELOW, David A, Barbara A GREGSON, Elise N ROWAN, Gordon D MURRAY, Anil GHOLKAR a Patrick M MITCHELL. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. \textit{Lancet}. NEW YORK: ELSEVIER SCIENCE INC, 2013, roč.~382, č.~9890, s.~397-408. ISSN~0140-6736. Dostupné z: https://dx.doi.org/10.1016/S0140-6736(13)60986-1.
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