P.018 Minimally invasive endoscopic evacuation of intraparenchymal hematomas, a single centre experience
Bibliographic record
Abstract
Background: Patients with spontaneous intracerebral hemorrhage (ICH) suffer significant morbidity and mortality with lengthy critical care and hospital stays. Minimally invasive techniques for ICH removal have shown a positive relationship between hemorrhage volume reduction and patient outcome. We describe our single centre experience with endoscopic assisted, neuronavigation guided ICH evacuation using the Apollo system. Methods: Patients with ICH treated with the Apollo system since October 2014 were included in this retrospective review. ICH volume, clot reduction, midline shift, ICU and hospital length of stay, discharge disposition and last known functional outcome were assessed. Results: 58 patients were treated, mean age 54.1 years. Starting clot volume was 55.1±30.5cc, which was reduced to 10.2±12cc post-operatively, an average reduction of 80.6±25%. Midline shift improved from 7.1±4.5mm to 4.4±3.2mm. Length of ICU stay was 10.2±7.6 days. Covariate analysis showed greater relative reduction in ICH volume correlated with shorter ICU stay (p=0.01). In-hospital mortality was 27.3%; 29.1% of patients were discharged home either form hospital directly, or after a period of short-stay rehab. Conclusions: Significant hematoma volume reduction and improvement in midline shift is possible with the Apollo system. Degree of reduction of hematoma volume was associated with a shorter ICU Stay. Randomized controlled studies will be required to determine long term clinical benefit.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".