Abstract Number: Esoc2026a2037 Real-World Surgical Outcomes of Primary Intracerebral Hemorrhage in a Provincial Stroke Center in Vietnam

Abstract Background and aims Surgery in primary intracerebral hemorrhage remains controversial, particularly in low- and middle-income countries, where available resources differ from large-scale randomized trials. Data from provincial stroke centers are limited. This study aimed to evaluate surgical outcomes and identify prognostic factors in patients with intracerebral hemorrhage treated at a provincial stroke center in Vietnam. Methods We conducted a retrospective review of consecutive patients with primary intracranial hemorrhage who underwent surgery at the Phu Tho Stroke Center from January 2024 to May 2025. Baseline clinical data, admission Glasgow Coma Scale (GCS) scores and computed tomography characteristics were collected. Results included GCS scores at discharge and modified Rankin (mRS) scores after 90 days. Multivariable logistic regression was used to identify independent factors associated with poor functional outcomes, defined as mRS scores from 4 to 6. Results The study included 49 patients, with a mean age of 58.7 years, and 75.5% were male. Hypertension was common, accounting for 83.7% of patients. Most hemorrhages occurred supratentorially, particularly involving the basal ganglia and thalamus. Average hematoma volume was 45 milliliters. Intraventricular hemorrhage was observed in 69.3% of cases. After 90 days, 60.5% achieved favorable functional outcomes. Low GCS scores at admission (5 to 8) and hematoma volumes of 60 milliliters or more were independently associated with poor outcomes. Conclusions In a real-world setting of a provincial stroke center, surgical treatment for selected patients with primary intracerebral hemorrhage was associated with acceptable functional outcomes. Admission neurological status and hematoma volume remain critical factors for surgical decision-making in resource-limited settings. Conflict of interest Linh NGUYEN: nothing to disclose. Duy-Ton Mai: nothing to disclose. PHUONG DAO: nothing to disclose. Ha TRAN: nothing to disclose.