Long-term mortality and time to minimally invasive puncture and drainage in spontaneous intracerebral hemorrhage

Objectives Minimally invasive puncture and drainage (MIPD) is a safe and effective treatment for spontaneous intracerebral hemorrhage (sICH). However, the impact of time to evacuation on clinical outcomes remains unclear. This study aims to assess the association between the time from symptom onset to MIPD and long-term mortality. Methods The study retrospectively included consecutive patients with a hematoma ≥ 20 mL who underwent MIPD within 24 h of symptom onset. Patients were stratified by different time windows (0–6 h, 6–12 h, and 12–24 h) from symptom onset to MIPD. One-year (long-term) mortality was defined as the primary outcome. Secondary outcomes included the incidence of rebleeding, the Glasgow Coma Scale (GCS) score at discharge, and modified Rankin Scale (mRS) scores at 3 and 6 months. The association between time to evacuation and clinical outcomes was assessed using multivariate logistic regression and inverse probability of treatment weighting (IPTW) analysis. Results A total of 214 eligible patients were included in our study. Patients who underwent MIPD within 6 h or 6 to 12 h had a higher long-term mortality rate compared to those treated within 12 to 24 h (48.48, 50.56, and 30.34%, respectively; p = 0.02). In IPTW analysis, undergoing MIPD within 12–24 h of symptom onset was associated with reduced short-term mortality [odds ratio (OR), 0.519; 95%CI (0.290–0.929), p = 0.03] and long-term mortality [OR, 0.530; 95% CI (0.300–0.937), p = 0.03]. Conclusion In patients with sICH, the time to MIPD within 12 to 24 h was associated with a decreased risk of long-term mortality.