scholarly journals Acute Surgery for Subarachnoid Hemorrhage Patients 80 Years of Age or Older with Surgical Indication: Does Surgery Improve Clinical Outcomes?

2015 ◽  
Vol 43 (6) ◽  
pp. 454-458
Author(s):  
Yukinori IMAO ◽  
Makoto OKADA
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcomes ◽  
Surgical Indication ◽  
Acute Surgery

Alanine Aminotransferase Predicts Outcomes in Elderly Patients with Aneurysmal Subarachnoid Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 89-95
Author(s):  
Jianfeng Zheng ◽  
Rui Xu ◽  
Zongduo Guo ◽  
Xiaochuan Sun
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Laboratory Data ◽  
Cardiac Complications ◽  
World Population ◽  
Systemic Complications ◽  
Poor Outcome ◽  
Poor Outcomes

Objective: With the aging of the world population, the number of elderly patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) is gradually growing. We aim to investigate the potential association between plasma ALT level and clinical complications of elderly aSAH patients, and explore its predictive value for clinical outcomes of elderly aSAH patients. Methods: Between January 2013 and March 2018, 152 elderly aSAH patients were analyzed in this study. Clinical information, imaging findings and laboratory data were reviewed. According to the Glasgow Outcome Scale (GOS), clinical outcomes at 3 months were classified into favorable outcomes (GOS 4-5) and poor outcomes (GOS 1-3). Logistic regression analysis was used to assess the indicators associated with poor outcomes, and receiver curves (ROC) and corresponding area under the curve (AUC) were used to detect the accuracy of the indicator. Results: A total of 48 (31.6 %) elderly patients with aSAH had poor outcome at 3 months. In addition to ICH, IVH, Hunt-Hess 4 or 5 Grade and Modified Fisher 3 or 4 Grade, plasma ALT level was also strongly associated with poor outcome of elderly aSAH patients. After adjusting for other covariates, plasma ALT level remained independently associated with pulmonary infection (OR 1.05; 95% CI 1.00–1.09; P = 0.018), cardiac complications (OR 1.05; 95% CI 1.01–1.08; P = 0.014) and urinary infection (OR 1.04; 95% CI 1.00–1.08; P = 0.032). Besides, plasma ALT level had a predictive ability in the occurrence of systemic complications (AUC 0.676; 95% CI: 0.586– 0.766; P<0.001) and poor outcome (AUC 0.689; 95% CI: 0.605–0.773; P<0.001) in elderly aSAH patients. Conclusion: Plasma ALT level of elderly patients with aSAH was significantly associated with systemic complications, and had additional clinical value in predicting outcomes. Given that plasma ALT levels on admission could help to identify high-risk elderly patients with aSAH, these findings are of clinical relevance.

Association between HbA1C (glycated hemoglobin) and clinical outcomes in patients with subarachnoid hemorrhage after neuro-intervention

2021 ◽  
Vol 18 ◽  
Author(s):  
Chan Woong Park ◽  
Ho Jun Yi ◽  
Dong Hoon Lee ◽  
Jae Hoon Sung
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Glycated Hemoglobin ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Unfavorable Clinical Outcome ◽  
High Hba1c

Objective: Our study investigated the association between level of HbA1c (glycated hemoglobin) at admission and the prognosis of aneurysmal subarachnoid hemorrhage (SAH). Methods: A total of 510 patients treated with neuro-intervention for aneurysmal SAH and with data for admission HbA1c (glycated hemoglobin) were included. Favorable clinical outcome was defined as Modified Rankin Scale (mRS) score of 0–2 at 3 months. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal cutoff value of HbA1C for unfavorable clinical outcomes. Logistic regression was used to evaluate the association between HbA1C level and outcomes. Results: The optimal cutoff value of HbA1C was identified as 6.0% (P < 0.001), and patients with a high HbA1C (≥ 6.0%) had a lower prevalence of favorable clinical outcomes than patients with low HbA1C (< 6.0%) (P < 0.001). High HbA1C (≥ 6.0%) was independently associated with unfavorable clinical outcome (OR 2.84; 95% CI: 1.52-5.44; P = 0.004). The risk of unfavorable clinical outcome was significantly increased in patients with HbA1C (≥ 7.0%, < 8%) and HbA1C (≥ 8.0%) compared with lower baseline HbA1C (≥ 6.0%, < 7%) values (OR 2.17; 95% CI: 1.87-5.13; P = 0.011 and OR 4.25; 95% CI: 3.17-8.41; P = 0.005). Conclusions: Our study showed that HbA1C could be an independent predictor of worse outcome following neuro-intervention for aneurysmal SAH. High HbA1C (≥ 6.0%) was associated with unfavorable clinical outcome, and gradual elevation of HbA1C contributed to an increase in the risk of worse clinical outcome after SAH.

Early prediction of clinical outcomes in patients with aneurysmal subarachnoid hemorrhage using computed tomography texture analysis

2020 ◽  
Vol 71 ◽  
pp. 144-149 ◽  
Author(s):  
Tokunori Kanazawa ◽  
Satoshi Takahashi ◽  
Yasuhiro Minami ◽  
Masahiro Jinzaki ◽  
Masahiro Toda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Texture Analysis ◽  
Clinical Outcomes ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Early Prediction

Impact of hospital-acquired complications in long-term clinical outcomes after subarachnoid hemorrhage

2020 ◽  
Vol 194 ◽  
pp. 105945
Author(s):  
Santiago R. Unda ◽  
Kevin Labagnara ◽  
Jessie Birnbaum ◽  
Megan Wong ◽  
Neranjan de Silva ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcomes ◽  
Hospital Acquired

scholarly journals Correlation Between ED Symptoms and Clinical Outcomes in the Patient with Aneurysmal Subarachnoid Hemorrhage

2012 ◽  
Vol 38 (3) ◽  
pp. 226-233 ◽  
Author(s):  
Kristin Adkins ◽  
Elizabeth Crago ◽  
Chien-Wen J. Kuo ◽  
Michael Horowitz ◽  
Paula Sherwood
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcomes ◽  
Aneurysmal Subarachnoid Hemorrhage

Risks factors for cerebral infarction in good-grade patients after aneurysmal subarachnoid hemorrhage and surgery: a prospective study

1991 ◽  
Vol 74 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Juha Öhman ◽  
Antti Servo ◽  
Olli Heiskanen
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Cerebral Infarction ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Ct Scanning ◽  
Cerebral Infarcts ◽  
Content Type ◽  
Acute Surgery ◽  
Significant Difference ◽  
History Of ◽  
A Prospective Study

✓ A prospective series of 265 patients with aneurysmal subarachnoid hemorrhage (SAH) of Grades I to III (Hunt and Hess classification) upon admission were evaluated as to neurological outcome and computerized tomography (CT) findings 1 to 3 years (mean 1.4 years) after the SAH and surgery. A total of 73 patients underwent acute surgery (within 72 hours after the bleed: Days 0 to 3), 86 were operated on subacutely (between Days 4 and 7), and 91 had late surgery (on Day 8 or later). Fifteen patients died before surgery was undertaken and another 20 patients died during the follow-up period. A total of 104 patients received nimodipine and the rest of the patients received either placebo (109 patients) or no medication (52 patients). A logistical regression analysis revealed the following prognostic factors for cerebral infarction, in order of importance: the amount of blood on the primary CT scan; postoperative angiographic vasospasm; the timing of the operation; and a history of hypertension. The use of nimodipine was associated with a significant reduction of cerebral infarcts visualized by CT scanning in patients who received intermediate or late surgery. In patients who underwent acute surgery no significant difference between the incidence of cerebral infarcts was observed.

scholarly journals Endovascular Treatment of Tiny Aneurysms With Low-Profile Visualized Intraluminal Support Devices Using a “Compressed” Stent Technique

2020 ◽  
Vol 11 ◽  
Author(s):  
Yangyang Zhou ◽  
Qichen Peng ◽  
Xinzhi Wu ◽  
Yisen Zhang ◽  
Jian Liu ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Outcomes ◽  
Study Cohort ◽  
Modified Rankin Scale ◽  
Safety And Efficacy ◽  
Acute Thrombosis ◽  
Clinical Applicability ◽  
Low Profile ◽  
Support Devices

Objective: To investigate the safety and efficacy of low-profile visualized intraluminal support (LVIS) stent-assisted coiling of intracranial tiny aneurysms using a “compressed” stent technique.Methods: We retrospectively analyzed patients with tiny aneurysms treated in our hospital with LVIS devices using a compressed stent technique. We analyzed patients' imaging outcomes, clinical outcomes, and complications.Results: Forty-two tiny aneurysms in 42 patients were included in this study cohort; 8 patients presented with subarachnoid hemorrhage at admission. The immediate postoperative complete embolization rate was 76.2% (32/42). After an average of 8.5 months of imaging follow-up, the complete embolization rate was 90.5% (38/42), and no aneurysm recanalization occurred. After an average of 24.4 months of clinical follow-up, 95.2% (40/42) of the patients achieved favorable clinical outcomes (modified Rankin scale = 0/1). Operation-related complications occurred in two patients (4.8%); one intraoperative acute thrombosis, and one significant unilateral decreased vision during the postoperative follow-up.Conclusion: LVIS stent-assisted coiling of intracranial tiny aneurysms using a compressed stent technique is safe and effective. Combined stent compression technology is beneficial to maximize the complete embolization of aneurysms and reduce aneurysm recanalization. This study expands the clinical applicability of LVIS stents.

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