Meng Qi1, Lidan Jiang1, Yueqiao Xu1, Xin Qu1, Na Wang1, Wenjin Chen1, Weitao Cheng1, Ning Wang2. 1. Intensive Care Unit, Department of Neurosurgery, Capital Medical University Xuanwu Hospital, Beijing, 100053, China. 2. Intensive Care Unit, Department of Neurosurgery, Capital Medical University Xuanwu Hospital, Beijing, 100053, China. wangning_dr88@163.com.
Abstract
INTRODUCTION: To investigate the risk factors affecting the prognosis of elderly patients with severe aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Forty-nine elderly patients with severe aSAH (Hunt and Hess [H-H] grade III-V) were enrolled in this retrospective study. Follow-up was conducted with patients 30 days after discharge using the Glasgow Outcome Scale (GOS), on which scores of 1-3 indicated a poor outcome (n = 32) and scores of 4-5 indicated a good outcome (n = 17). The patients' general information (gender, age, presence of hypertension, diabetes, or coronary atherosclerotic heart disease, location of ruptured aneurysm, and H-H grade) and complications (cerebral vasospasm, new cerebral infarction, pulmonary infection, liver dysfunction, hypoalbuminemia, anemia, and electrolyte disturbance) were recorded, and comparison between the different outcome groups was undertaken. Univariate analysis was used to analyze the factors associated with different outcomes, and multivariate logistic regression analysis was used to determine the factors that lead to poor outcomes. RESULTS: The incidence of all complications increased in patients with higher H-H grades, but without statistical significance (P > 0.05). There was no statistically significant difference between the two outcome (poor and good) groups in general information and complications (all P > 0.05), with the exception of different H-H grades (P < 0.05). H-H grade was a statistically significant risk factor for poor outcomes in elderly patients with severe aSAH (OR 11.627, 95% CI 2.475-55.556, P = 0.002). CONCLUSION: H-H grade is an independent factor related to the prognosis of elderly patients with severe aSAH.
INTRODUCTION: To investigate the risk factors affecting the prognosis of elderly patients with severe aneurysmal subarachnoid hemorrhage (aSAH). METHODS: Forty-nine elderly patients with severe aSAH (Hunt and Hess [H-H] grade III-V) were enrolled in this retrospective study. Follow-up was conducted with patients 30 days after discharge using the Glasgow Outcome Scale (GOS), on which scores of 1-3 indicated a poor outcome (n = 32) and scores of 4-5 indicated a good outcome (n = 17). The patients' general information (gender, age, presence of hypertension, diabetes, or coronary atherosclerotic heart disease, location of ruptured aneurysm, and H-H grade) and complications (cerebral vasospasm, new cerebral infarction, pulmonary infection, liver dysfunction, hypoalbuminemia, anemia, and electrolyte disturbance) were recorded, and comparison between the different outcome groups was undertaken. Univariate analysis was used to analyze the factors associated with different outcomes, and multivariate logistic regression analysis was used to determine the factors that lead to poor outcomes. RESULTS: The incidence of all complications increased in patients with higher H-H grades, but without statistical significance (P > 0.05). There was no statistically significant difference between the two outcome (poor and good) groups in general information and complications (all P > 0.05), with the exception of different H-H grades (P < 0.05). H-H grade was a statistically significant risk factor for poor outcomes in elderly patients with severe aSAH (OR 11.627, 95% CI 2.475-55.556, P = 0.002). CONCLUSION: H-H grade is an independent factor related to the prognosis of elderly patients with severe aSAH.
Authors: Mustafa Kilic; Ilhan Yilmaz; Osman Tanriverdi; Cem Akgun; Ahmet Murat Musluman; Adem Yilmaz Journal: Turk Neurosurg Date: 2017 Impact factor: 1.003
Authors: Antti Lindgren; Mervyn DI Vergouwen; Irene van der Schaaf; Ale Algra; Marieke Wermer; Mike J Clarke; Gabriel Je Rinkel Journal: Cochrane Database Syst Rev Date: 2018-08-15