Factors associated with outcomes in ruptured aneurysmal patients: Clinical Study of 80 Patients

Alfotih, Gobran Taha Ahmed; Li, Fangcheng; Xu, Xinke; Shangyi, Zhang

doi:10.1515/romneu-2015-0013

Cited by 1 publication

(2 citation statements)

References 24 publications

(28 reference statements)

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“…Despite that, it is proven that early surgery prevents the risk of re-bleeding that usually occurs in the first 6 h after initial devastating neurology. Ahmed Alfotih et al (9) concluded that timing of surgery does not affect the outcome of patients, however, a study by Dorhout Mees et al (14) supports early aneurysm treatment, with both coiling and clipping, in SAH patients.…”

Section: Predicting Factors For Favourable Outcomesmentioning

confidence: 99%

“…In our observation, only 15.2% of the patients of WFNS grade IV and 6.7% of grade V were subjected to surgery. Mean (SD) timing of surgery after SAH was 5.3 (3.6) days and was further categorised into early (day 1 to day 3), intermediate (day 4 to day 10), and late (after day 10), according to Ahmed Alfotih et al (9). A majority of the surgeries were done in the intermediate group (n = 59) followed by early (n = 36) and late (n = 10).…”

Section: Patient Demographicsmentioning

confidence: 99%

See 1 more Smart Citation

The Factors Associated with Outcomes in Surgically Managed Ruptured Cerebral Aneurysm

Chee¹,

Siregar²,

Ghani³

et al. 2018

MJMS

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Failure to diagnose, delay in admission to a neurosurgical centre, and lack of facilities could have led to the poor surgical outcome in these patients. The purpose of this study is to identify the factors that significantly predict the outcome of patients undergoing a surgical clipping of ruptured aneurysm in the local population.Material and Method: A single center retrospective study with a review of medical records was performed involving 105 patients, who were surgically treated for ruptured intracranial aneurysms in the Sultanah Aminah Hospital, in Johor Bahru, from July 2011 to January 2016. Information collected was the patient demographic data, Glasgow Coma Scale (GCS) prior to surgery, World Federation of Neurosurgical Societies Scale (WFNS), subarachnoid hemorrhage (SAH) grading system, and timing between SAH ictus and surgery. A good clinical grade was defined as WFNS grade I-III, whereas, WFNS grades IV and V were considered to be poor grades. The outcomes at discharge and six months post surgery were assessed using the modified Rankin's Scale (mRS). The mRS scores of 0 to 2 were grouped into the "favourable" category and mRS scores of 3 to 6 were grouped into the "unfavourable" category. Only cases of proven ruptured aneurysmal SAH involving anterior circulation that underwent surgical clipping were included in the study. The data collected was analysed using the Statistical Package for Social Sciences (SPSS). Univariate and multivariate analyses were performed and a P-value of < 0.05 was considered to be statistically significant.Result: A total of 105 patients were included. The group was comprised of 42.9% male and 57.1% female patients. The mean GCS of the patients subjected to surgical clipping was 13, with the majority falling into the good clinical grade (78.1%). The mean timing of the surgery after SAH was 5.3 days and this was further categorised into early (day one to day three, 45.3%), intermediate (day four to day ten, 56.2%), and late (after day ten, 9.5%). The total favourable outcome achieved at discharge was 59.0% as compared to 41.0% of the unfavourable outcome, with an overall mortality rate of 10.5%. At the six-month post surgery review (n = 94), the patients with a favourable outcome constituted 71.3% as compared to 28.7% with an unfavourable outcome. The mortality, six months post surgery was 3.2%. On a univariate analysis of early surgical clipping, patients with a better GCS and good clinical grade had a significantly better outcome at MethodologyA single centre retrospective study with review of case notes was performed involving 105 patients, who were surgically treated for ruptured intracranial aneurysms from July 2011 until January 2016. Information collected included, the patient demographics, presenting symptoms, Glasgow Coma Scale (GCS) prior to surgery, timing between SAH ictus and surgery, duration of surgery, location of aneurysm, and maximum size of the aneurysm. A patient's preoperative neurological condition was classified using the World Federation of Neurosurg...

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Section: Predicting Factors For Favourable Outcomesmentioning

confidence: 99%

Section: Patient Demographicsmentioning

confidence: 99%