Natural course of subarachnoid hemorrhage is worse in elderly patients

Abstract

Aging is a major risk factor for poor outcome in patients with ruptured or unruptured intracranial aneurysms (IA) submitted to treatment. It impairs several physiologic patterns related to cerebrovascular hemodynamics and homeostasis. Objective: Evaluate clinical, radiological patterns and prognostic factors of subarachnoid hemorrhage (SAH) patients according to age. Method: Three hundred and eighty nine patients with aneurismal SAH from a Brazilian tertiary institution (Hospital do Servidor Público Estadual de São Paulo) were consecutively evaluated from 2002 to 2012 according to Fisher and Hunt Hess classifications and Glasgow Outcome Scale. Results: There was statistically significant association of age with impaired clinical, radiological presentation and outcomes in cases of SAH. Conclusion: Natural course of SAH is worse in elderly patients and thus, proper recognition of the profile of such patients and their outcome is necessary to propose standard treatment.

Functional outcome 1 year after aneurysmal subarachnoid hemorrhage due to ruptured intracranial aneurysm in elderly patients

“…However, recent retrospective series of EV and MS reported favorable progression in 25-60% of patients, and a significant reduction of mortality (6,10,11,14,16,21,38,39). The present prospective series showed that, after EV or MS treatment, patients with good initial clinical status (WFNS I-III) not only had relatively low mortality (between 15% and 18%); more importantly, the proportion of dependent patients was identical to that in younger patients.…”

“…Population aging in Western countries raises questions about extending treatment indications in elderly patients with aneurysmal subarachnoid hemorrhage (aSAH). According to retrospective studies, natural history and clinical outcome at 3 months after endovascular coiling (EV) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) or microsurgical clipping (MS) (6,7,(11)(12)(13)(14)(15)(16) are favorable only in 50-60% of patients older than 70 years. Of note, this trend is also confirmed in patients in their 8 th or 9 th decade of life (17)(18)(19)(20).…”

Mortality among patients with subarachnoid hemorrhage: a retrospective study

“…In accordance with the findings of our study, Pahl et al also concluded that ageing is a risk factor for poor outcomes in patients with ruptured or unruptured intracranial aneurysms. 24 The model also showed that the intercept was significant too, which implicated that there could be other independent variables than those included in this model which could predispose the occurrence of SH. There are several systems for the classification of SH.…”

Epidemiological characteristics and causes of death after Aneurysmal Subarachnoid Hemorrhage – SAH

“…The sociodemographic characteristics of the study sample are similar to other studies already described, since the highest occurrence is in women. 3,11,12 This ictus was present in 65% women, with 53% of them in the age range between 41 and 60 years old. Published series on cerebral aneurysm warn that age is an important data to be considered, as they are rare in children and the incidence increases according to age in both sexes.…”