Causes of Poor Outcome in Patients Admitted with Good-grade Subarachnoid Haemorrhage

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F27283933%3A_____%2F17%3A00005320" target="_blank" >RIV/27283933:_____/17:00005320 - isvavai.cz</a>

Result on the web

<a href="http://link.springer.com/content/pdf/10.1007/s00701-017-3081-8.pdf" target="_blank" >http://link.springer.com/content/pdf/10.1007/s00701-017-3081-8.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1007/s00701-017-3081-8" target="_blank" >10.1007/s00701-017-3081-8</a>

Result language

angličtina

Original language name

Causes of Poor Outcome in Patients Admitted with Good-grade Subarachnoid Haemorrhage

Original language description

Surgical risk in patients with unruptured aneurysms is well known. The relative impact of surgery and natural history of subarachnoid haemorrhage (SAH) on patients in good clinical condition (World Federation of Neurological Surgeons [WFNS] grades 1 and 2) is less well quantified. The aim of this study was to determine causes of poor outcome in patients admitted in good grade SAH. Methods: A retrospective study of prospectively collected data among WFNS-1 and -2 patients: demographics, SAH and aneurysm-related data, surgical complications and outcome as assesed by the Glasgow Outcome Scale (GOS). Causes of poor outcome (GOS 1–3) were determined. Results: During a 7-year period (2009–15), 56 patients with SAH WFNS-1 (39 patients) or WFNS-2 (17 patients) were treated surgically (21 men, 35 women; mean age, 52.4 years). According to the Fisher scale, 19 patients were grade 1 or 2; 37 patients were grade 3 or 4. Most aneurysms were located at anterior communicating (26) or middle cerebral (15) artery. Altogether, 11 patients (19.6%) achieved GOS 1–3. This was attributed to SAH-related complications in six patients (rebleeding, vasospasm), surgery in four patients (postoperative ischaemia in two, haematoma and ventriculitis in one patient each), grand-mal seizure with aspiration in one patient. Age over 60 years (p = 0.017) and presence of hydrocephalus (p < 0.001) were statistically significant predictors of poor GOS; other variables (e.g. sex, Fisher grade, aneurysm size or location, use of temporary clips, intraoperative rupture, vasospasm) were not significant. Conclusions: Patients admitted in good-grade SAH achieve favourable outcome following surgical aneurysm repair in the majority of cases. Negative factors include age over 60 years and presence of hydrocephalus. Aneurysm surgery following good-grade SAH still carries a small but significant risk similar to that shown in large multi-institutional trials.

Czech name

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Czech description

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Type

J_SC - Article in a specialist periodical, which is included in the SCOPUS database

CEP classification

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OECD FORD branch

30210 - Clinical neurology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Acta Neurochirurgica

ISSN

0001-6268

e-ISSN

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Volume of the periodical

159

Issue of the periodical within the volume

3

Country of publishing house

AT - AUSTRIA

Number of pages

7

Pages from-to

559-565

UT code for WoS article

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EID of the result in the Scopus database

2-s2.0-85009853990