Elderly Age as a Prognostic Marker of 1-year Poor Outcome for Subarachnoid Hemorrhage Patients through Its Interaction with Admission Hydrocephalus

Degos, Vincent; Gourraud, Pierre-Antoine; Tursis, Virginie Trehel; Whelan, Rachel; Colonne, Chantal; Korinek, Anne Marie; Clarençon, Frédéric; Boch, A.-L.; Nouet, Aurélien; Young, William L.; Apfel, Christian C.; Puybasset, Louis

doi:10.1097/aln.0b013e318267395b

Cited by 33 publications

(23 citation statements)

References 51 publications

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“…demonstrated that prenatal morphine exposure differentially altered the performance of adult male and female rats on tasks requiring learning and spatial memory (Slamberova et al, 2001a). Another group reported disturbance in a passive avoidance retention task in females after intrauterine morphine treatment (Degos et al, 2012). We found a significant gender-treatment interaction in the case of stressorinduced blood glucose elevation as well (Fig.…”

Section: Animal Studiessupporting

confidence: 58%

Behavioral effects of perinatal opioid exposure

2014

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Section: Animal Studiessupporting

confidence: 58%

Behavioral effects of perinatal opioid exposure

2014

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“…18,23,24 The rate of poor outcome and mortality at 1 year in our cohort was lower than the results reported in other previous studies. 7,22,25 It may be because that the cut-off age for elderly patients in our study was 60 years old and younger than these previous studies. After classification of age, our results shown 75 years old is a critical age which affecting outcome for elderly aSAH patients underwent EVT.…”

Section: Discussionmentioning

confidence: 52%

“…5,6,11,25 However, the contribution made by each specific predictor remains unknown for elderly aSAH patients. Not surprisingly, Fisher grade has the most profound influence on 1-year poor outcomes, followed by periprocedural complications and Hunt–Hess grade.…”

Section: Discussionmentioning

confidence: 99%

Prognosis Predicting Score for Endovascular Treatment of Aneurysmal Subarachnoid Hemorrhage

Duan

Yang

et al. 2016

Medicine

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The elderly patients with aneurysmal subarachnoid hemorrhage (aSAH) have a greater risk of poor clinical outcome after endovascular treatment (EVT) than younger patients do. Hence, it is necessary to explore which factors are associated with poor outcome and develop a predictive score specifically for elderly patients with aSAH receiving EVT.The aim of this study was to develop and validate a predictive score for 1-year outcomes in individual elderly patients with aSAH underwent EVT.In this 10-year prospective study, 520 consecutive aSAH elderly (age ≥ 60 years) patients underwent EVT in a single center were included. The risk factors, periprocedural, and 1-year follow-up data of all patients were entered in a specific prospective database.The modified Rankin scale was used for evaluating clinical outcome. To optimize the model's predictive capacity, the original matrix was randomly divided in 2 submatrices (learning and testing). The predictive score was developed using Arabic numerals for all variables based on the variable coefficients (β) of multivariable logistic regression analysis in the learning set and the predictive performance evaluation was assessed in the testing set. The risk classes were constructed using classification criteria based on sensitivity and specificity.The poor outcome rate at 1 year was 26.15%. Six risk factors, including age, hypertension, Hunt–Hess scale, Fisher scale, aneurysm location, and periprocedural complications, were independently associated with poor outcome and assembled the Changhai score. The discriminative power analysis with the area under the receiver operating characteristic curve (AUC) of the Changhai score was statistically significant (0.864, 0.824–0.904, P < 0.001). The sensitivity and specificity of the Changhai score were 82.07% and 78.06%, respectively.Our study indicated that age, hypertension, Hunt–Hess scale, Fisher scale, aneurysm location, and periprocedural complications were independent risk factors of poor outcome for elderly aSAH patients underwent EVT. In combination with these risk factors, the Changhai score can be a useful tool in the prediction of clinical outcome but needs to be validated in various centers before it can be recommended for application.

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“…Indeed, even if elderly patients (70 years) present comorbidities that may hamper the clinical outcome, 37 % of them will have a good clinical outcome at long-term follow-up after endovascular coiling of a ruptured aneurysm, independently from the initial WFNS score at admission [100]. However, hydrocephalus in elderly patients may be associated with a worse clinical outcome [101]. Finally, some scores combining clinical and biomarker data, like the ABC score [102], have been proposed to predict the 1-year clinical outcome in patients with coiled ruptured aneurysms.…”

Section: Prognostic Factorsmentioning

confidence: 96%

Aneurysmal Subarachnoid Hemorrhage

Clarençon¹,

Sourour²,

Degos³

et al. 2015

Neurovascular Imaging

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Intracranial aneurysms are a non-exceptional disease affecting 1-3 % of the general population. The incidence of aneurysmal subarachnoid hemorrhage (SAH) is about 1/10,000/year. Aneurysmal SAH is a devastating disease leading to death approximately in 50 % of the cases and to neurological sequels in about 25 % of the cases. Management of aneurysmal SAH consists in early exclusion of the aneurysm's sac either by endovascular means or by microsurgical clipping. Intensive care management is of tremendous importance to treat SAH-related complications like hydrocephalus and to prevent delayed complications such as vasospasm. Current perspectives for intracranial aneurysms management consist in a better selection of the unruptured aneurysms to treat, in order to propose a preventive treatment of exclusion before they bleed.

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Elderly Age as a Prognostic Marker of 1-year Poor Outcome for Subarachnoid Hemorrhage Patients through Its Interaction with Admission Hydrocephalus

Abstract: In this observational study, elderly age and admission hydrocephalus predicted poor outcome, but elderly age without hydrocephalus did not. An external validation, however, will be needed to generalize this finding.

Cited by 33 publications

References 51 publications

Behavioral effects of perinatal opioid exposure

Behavioral effects of perinatal opioid exposure

Prognosis Predicting Score for Endovascular Treatment of Aneurysmal Subarachnoid Hemorrhage

Aneurysmal Subarachnoid Hemorrhage

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