Literature DB >> 25216063

Subarachnoid hemorrhage and the female sex: analysis of risk factors, aneurysm characteristics, and outcomes.

Alhafidz Hamdan1, Jonathan Barnes, Patrick Mitchell.   

Abstract

OBJECT: The pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH) is unclear. Sex may play a role in the outcome of patients with aSAH.
METHODS: The authors retrospectively identified 617 patients with aSAH (April 2005 to February 2010) and analyzed sex differences in risk factors (age, hypertension, smoking, alcohol consumption, and family history), admission-related factors (World Federation of Neurosurgical Societies grade and admission delay), aneurysm characteristics (site, side, location, and multiplicity), and outcomes (treatment modalities [coiling/clipping/both/conservative], complications [vasospasm and hydrocephalus], length of stay, and modified Rankin Scale score at 3 months).
RESULTS: The female patients with aSAH were older than the male patients (mean age 56.6 vs 51.9 years, respectively, p < 0.001), and more women than men were ≥ 55 years old (56.2% vs 40.4%, respectively, p < 0.001). Women exhibited higher rates of bilateral (6.8% vs 2.6%, respectively, p < 0.05), multiple (11.5% vs 5.2%, respectively, p < 0.05), and internal carotid artery (ICA) (36.9% vs 17.5%, respectively, p < 0.001) aneurysms and a lower rate of anterior cerebral artery aneurysms (26.3% vs 44.8%, respectively, p < 0.001) than the men, but no side differences were noted. There were no sex differences in risk factors, admission-related factors, or outcome measures. For both sexes, outcomes varied according to aneurysm location, with odds ratios for a poor outcome of 1.62 (95% CI 0.91-2.86, p = 0.1) for middle cerebral artery, 2.41 (95% CI 1.29-4.51, p = 0.01) for ICA, and 2.41 (95% CI 1.29-4.51, p = 0.006) for posterior circulation aneurysms compared with those for anterior cerebral artery aneurysms. The odds ratio for poor outcome (modified Rankin Scale score of 4-6) in women compared with men after adjusting for significant prognostic factors was 0.71 (95% CI 0.45-1.11, p > 0.05).
CONCLUSIONS: The overall outcomes after aSAH between women and men are similar.

Entities:  

Keywords:  ACA = anterior cerebral artery; ICA = internal carotid artery; MCA = middle cerebral artery; PC = posterior circulation; WFNS = World Federation of Neurosurgical Societies; aSAH = aneurysmal subarachnoid hemorrhage; aneurysm; female; mRS = modified Rankin Scale; outcome; sex; subarachnoid hemorrhage; vascular disorders

Mesh:

Year:  2014        PMID: 25216063     DOI: 10.3171/2014.7.JNS132318

Source DB:  PubMed          Journal:  J Neurosurg        ISSN: 0022-3085            Impact factor:   5.115


  26 in total

1.  Sexual dimorphism in gene expression after aneurysmal subarachnoid hemorrhage.

Authors:  Victor Friedrich; Weina Bi; Fatima A Sehba
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2.  Development and internal validation of an aneurysm rupture probability model based on patient characteristics and aneurysm location, morphology, and hemodynamics.

Authors:  Felicitas J Detmer; Bong Jae Chung; Fernando Mut; Martin Slawski; Farid Hamzei-Sichani; Christopher Putman; Carlos Jiménez; Juan R Cebral
Journal:  Int J Comput Assist Radiol Surg       Date:  2018-08-09       Impact factor: 2.924

3.  MRI Characterization in the Acute Phase of Experimental Subarachnoid Hemorrhage.

Authors:  Dewei Guo; D Andrew Wilkinson; B Gregory Thompson; Aditya S Pandey; Richard F Keep; Guohua Xi; Ya Hua
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4.  Development of a statistical model for discrimination of rupture status in posterior communicating artery aneurysms.

Authors:  Felicitas J Detmer; Bong Jae Chung; Fernando Mut; Michael Pritz; Martin Slawski; Farid Hamzei-Sichani; David Kallmes; Christopher Putman; Carlos Jimenez; Juan R Cebral
Journal:  Acta Neurochir (Wien)       Date:  2018-06-20       Impact factor: 2.216

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6.  A magnetic resonance imaging grading system for subarachnoid hemorrhage severity in a rat model.

Authors:  Hajime Shishido; Yusuke Egashira; Shuichi Okubo; Haining Zhang; Ya Hua; Richard F Keep; Guohua Xi
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Review 7.  Sex Differences in the Formation of Intracranial Aneurysms and Incidence and Outcome of Subarachnoid Hemorrhage: Review of Experimental and Human Studies.

Authors:  Nefize Turan; Robert Allen-James Heider; Dobromira Zaharieva; Faiz U Ahmad; Daniel L Barrow; Gustavo Pradilla
Journal:  Transl Stroke Res       Date:  2015-11-16       Impact factor: 6.829

8.  Identification of specific age groups with a high risk for developing cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

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Journal:  Neurosurg Rev       Date:  2016-03-04       Impact factor: 3.042

9.  Prediction of rupture risk in anterior communicating artery aneurysms with a feed-forward artificial neural network.

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10.  Risk Factors for Unfavorable Outcome in Aneurysmal Subarachnoid Hemorrhage Revisited; Odds and Ends.

Authors:  Abdolkarim Rahmanian; Nima Derakhshan; Alireza Mohsenian Sisakht; Najme Karamzade Ziarati; Hadi Raeisi Shahraki; Soheil Motamed
Journal:  Bull Emerg Trauma       Date:  2018-04
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