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A National Cohort with Aneurysmal Subarachnoid Hemorrhage-Patient Characteristics, Choice of Treatment, Clinical Outcome, and Factors of Prognostic Importance.
Aineskog, Helena; Baldvinsdóttir, Bryndís; Ronne Engström, Elisabeth; Eneling, Johanna; Enblad, Per; Svensson, Mikael; Alpkvist, Peter; Fridriksson, Steen; Klurfan, Paula; Hillman, Jan; Kronvall, Erik; Nilsson, Ola G; Lindvall, Peter.
Afiliación
  • Aineskog H; Department of Clinical Sciences - Neurosciences, Umeå University, Umeå, Sweden. Electronic address: helena.aineskog@regionvasterbotten.se.
  • Baldvinsdóttir B; Department of Clinical Sciences - Neurosurgery, Lund University, Lund, Sweden.
  • Ronne Engström E; Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
  • Eneling J; Department of Clinical Sciences, Linköping University, Linköping, Sweden.
  • Enblad P; Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.
  • Svensson M; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
  • Alpkvist P; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
  • Fridriksson S; Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden.
  • Klurfan P; Department of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden.
  • Hillman J; Department of Clinical Sciences, Linköping University, Linköping, Sweden.
  • Kronvall E; Department of Clinical Sciences - Neurosurgery, Lund University, Lund, Sweden.
  • Nilsson OG; Department of Clinical Sciences - Neurosurgery, Lund University, Lund, Sweden.
  • Lindvall P; Department of Clinical Sciences - Neurosciences, Umeå University, Umeå, Sweden.
World Neurosurg ; 2024 Jul 29.
Article en En | MEDLINE | ID: mdl-39084286
ABSTRACT

OBJECTIVE:

To study associations of clinical characteristics and treatment choice with functional outcome, mortality, and time to death in a national sample of aneurysmal subarachnoidal hemorrhage patients.

METHODS:

Data were extracted from a prospective nationwide multicenter study performed in September 2014 to March 2018. Glasgow Outcome Scale Extended (GOSE) grade, 1-year mortality, and survival probability were assessed at one year after ictus. Logistic univariate, multivariate, and Cox regression analyses were used to study the variables' associations with the outcomes.

RESULTS:

Unfavorable dichotomized GOSE (dGOSE; grades 1-4) was observed in 35.4% of patients. Microsurgery was preferred for middle cerebral artery aneurysms and Fisher grade 4. Treatment modality was not associated with any outcome measure. Dichotomized World Federation of Neurosurgical Societies (dWFNS), age, and delayed ischemic neurological deficit (DIND) showed significant correlations with dGOSE and 1-year mortality in multivariate regression analyses. Pupil dilatation was associated with a 1-year mortality outcome. Cox regression analysis showed lower survival probability for pupil dilatation (hazard ratio [HR] 3.546), poor dWFNS (HR 3.688), higher age (HR 1.051), and DIND occurrence (HR 2.214).

CONCLUSIONS:

The patient selection in Sweden after aneurysmal subarachnoidal hemorrhage showed similar values for dGOSE, 1-year mortality, and survival probability between patients treated with microsurgery or endovascular technique. Poor dWFNS, higher age, and DIND were significantly associated with unfavorable dGOSE, mortality, and survival probability. Pupil dilatation was significantly associated with mortality and survival probability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos