One-Year Outcome After Aneurysmal Subarachnoid Hemorrhage in Elderly Patients

Virta, Jyri J.; Satopää, Jarno; Luostarinen, Teemu; Raj, Rahul

doi:10.1016/j.wneu.2020.07.127

Cited by 17 publications

(19 citation statements)

References 17 publications

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“…Comparative studies between the elderly versus younger age have indicated that women were predominant above the age of 65 years, 70 years, or with increasing age. 12,13 In the present study, ICH was the most common vascular diagnosis followed by SAH. ICH is a growing cause of mortality and morbidity worldwide, because of the increasing number of elderly people.…”

Section: Discussionmentioning

confidence: 49%

“…Therefore, antiplatelet therapy important factor in the overall clinical outcome. 4,12 In the current study, almost one-fifth of the patients received anticoagulant medications, mostly enoxaparin. Prior research on the risks of anticoagulation in patients who experience head injury have reported mixed results.…”

Section: Discussionmentioning

confidence: 89%

“…14 It is one of the important associated pathologies with strokes, as stated by Stein et al that approximately 20% of all strokes are due to ICH. 12 However, it is also important to remember two other, less common vascular entities: subdural and epidural hematoma, which are both frequently associated with head trauma, especially in the elderly, yet, those two entities were not in the scope of this paper. Thus, they will be discussed in a separate paper that describes traumatic brain injury in a specialized way.…”

Section: Discussionmentioning

confidence: 99%

“…The GCS is considered to an important factor in the prognosis of the patients, as elderly patients with low GCS and coagulopathy had poor prognoses. 12,14 Many patients had a GCS score of less than 8. In contrast with another study done by Cho and colleagues demonstrated a higher GCS score among both patients with a surgical and conservative type of management.…”

Section: Discussionmentioning

confidence: 99%

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Geriatric Cerebrovascular Neurosurgery: Institutional Experience from Khoula Hospital

Al-Mirza

Al-Taei

Al‐Saadi

2021

Int Clin Neurosci J

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Background: The aging of the healthy population without severe morbidity exposes them to cerebrovascular diseases and demand effective management. This study aimed to study the prevalence of geriatric cerebrovascular neurosurgical conditions in the Neurosurgical Department at Khoula Hospital, Muscat, Sultanate of Oman. Methods: A retrospective chart review of was done on geriatric cases admitted to the Neurosurgery Department in Khoula Hospital as an example of a neurosurgical center in a high-income developing country from January 2016 to 31st December 2019. Patients’ demographics, risk factors, diagnosis, Glasgow Coma Scale (GCS) on arrival, medications used, and length of stay were recorded. Results: 109 patients aged over 65 years were recruited in our retrospective review with a mean age of 74.12 years. Male-to-female ratio was (1.2:1). Intracerebral hemorrhage (ICH) was the most common vascular diagnosis (39.0%) followed by subarachnoid hemorrhage (SAH) (22.9%). Most patients (41.9%) had a GCS score of less than 8. About one-fifth of the patients received antiplatelet and anticoagulant medications. Most of the patients underwent surgical intervention (61.9%). 59% of the patients stayed in the hospital for less than 15 days. There were significant associations between the length of stay, treatment types (surgical vs. conservative), and age (P<0.05). Conclusion: Cerebrovascular pathologies are a growing cause of mortality and morbidity worldwide including developing countries because of the increasing number of elderly people. Antiplatelet medication and anticoagulants should be used with caution in the elderly.

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Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Geriatric Cerebrovascular Neurosurgery: Institutional Experience from Khoula Hospital

Al-Mirza

Al-Taei

Al‐Saadi

2021

Int Clin Neurosci J

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“…But Virta et al recently reported that getting older did not make the outcome worse. However, we still believe that more care should be given to patients over 60 years old [44].…”

Section: Risk Factorsmentioning

confidence: 98%

Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management

2021

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Hydrocephalus is one of the most common complications of aneurysmal subarachnoid hemorrhage (aSAH), which seriously affects the quality of life and shortens the survival time of affected patients. By reviewing the recent studies on the risk factors of aSAH-associated hydrocephalus, we aimed to explicitly present the pathogenesis of acute and chronic hydrocephalus after aSAH and make a comprehensive list of the associated risk factors of aSAH-associated hydrocephalus and shunt-dependent hydrocephalus. It would help us to better explain the occurrence of hydrocephalus after aSAH, especially hydrocephalus caused by inflammation after bleeding. Many studies have recently suggested that high mobility group box 1 may be an early upstream promoter of inflammatory response after aSAH, which also provides important ideas for us to look for potential drug treatments. The surgery, such as external ventricular drain and lumbar drainage, is the most common and effective treatment. Yet, there are often complications, such as rebleeding and intracranial infection, and the optimal timing of intervention is controversial. Besides, this is also a systematic review of the recent advances in epidemiology, pathogenesis, diagnosis, and management of aSAH-associated hydrocephalus.

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A visualized MAC nomogram online predicts the risk of three-month mortality in Chinese elderly aneurysmal subarachnoid hemorrhage patients undergoing endovascular coiling

Zhou

Zhang

et al. 2023

Neurol Sci

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Objective Aneurysmal subarachnoid hemorrhage (aSAH) is an aggressive disease with higher mortality rate in the elderly population. Unfortunately, the previous models for predicting clinical prognosis are still not accurate enough. Therefore, we aimed to construct and validate a visualized nomogram model to predict online the 3-month mortality in elderly aSAH patients undergoing endovascular coiling. Method We conducted a retrospective analysis of 209 elderly aSAH patients at People’s Hospital of Hunan Province, China. A nomogram was developed based on multivariate logistic regression and forward stepwise regression analysis, then validated using the bootstrap validation method ( n = 1000). In addition, the performance of the nomogram was evaluated by various indicators to prove its clinical value. Result Morbid pupillary reflex, age, and using a breathing machine were independent predictors of 3-month mortality. The AUC of the nomogram was 0.901 (95% CI: 0.853–0.950), and the Hosmer–Lemeshow goodness-of-fit test showed good calibration of the nomogram ( p = 0.4328). Besides, the bootstrap validation method internally validated the nomogram with an area under the curve of the receiver operator characteristic (AUROC) of 0.896 (95% CI: 0.846–0.945). Decision curve analysis (DCA) and clinical impact curve (CIC) indicated the nomogram’s excellent clinical utility and applicability. Conclusion An easily applied visualized nomogram model named MAC (morbid pupillary reflex-age-breathing machine) based on three accessible factors has been successfully developed. The MAC nomogram is an accurate and complementary tool to support individualized decision-making and emphasizes that patients with higher risk of mortality may require closer monitoring. Furthermore, a web-based online version of the risk calculator would greatly contribute to the spread of the model in this field.

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One-Year Outcome After Aneurysmal Subarachnoid Hemorrhage in Elderly Patients

Cited by 17 publications

References 17 publications

Geriatric Cerebrovascular Neurosurgery: Institutional Experience from Khoula Hospital

Geriatric Cerebrovascular Neurosurgery: Institutional Experience from Khoula Hospital

Hydrocephalus after aneurysmal subarachnoid hemorrhage: Epidemiology, Pathogenesis, Diagnosis, and Management

A visualized MAC nomogram online predicts the risk of three-month mortality in Chinese elderly aneurysmal subarachnoid hemorrhage patients undergoing endovascular coiling

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