Effect of treatment modality and cerebral vasospasm agent on patient outcomes after aneurysmal subarachnoid hemorrhage in the elderly aged 75 years and older

Ido, Keisuke; Kurogi, Ryota; Kurogi, Ai; Nishimura, Kunihiro; Arimura, Koichi; Nishimura, Ataru; Ren, Nice; Kada, Akiko; Matsuo, Ryu; Onozuka, Daisuke; Hagihara, Akihito; Takagishi, So; Yamagami, Keitaro; Takegami, Misa; Nohara, Yasunobu; Nakashima, Naoki; Kamouchi, Masahiro; Date, Isao; Kitazono, Takanari; Iihara, Koji

doi:10.1371/journal.pone.0230953

Cited by 25 publications

(14 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, surgical aneurysm closure was associated with unfavorable outcome and mortality at 12 months only in the older age group. In contrast, most of previous studies have found no differences between surgical and endovascular treatment in the elderly [12,22,25].…”

Section: Comparison With Previous Literaturecontrasting

confidence: 57%

Neurointensive care results and risk factors for unfavorable outcome in aneurysmatic SAH: a comparison of two age groups

et al. 2021

View full text Add to dashboard Cite

Background The mean age of actively treated subarachnoid hemorrhage (SAH) patients is increasing. We aimed to compare outcomes and prognostic factors between older and younger SAH patients. Methods A retrospective single-center analysis of aneurysmal SAH patients admitted to a neuro-ICU during 2014–2019. We defined older patients as ≥70 years and younger patients as <70 years. For every older patient, we identified three younger patients with the same World Federation of Neurological Surgeons (WFNS) grade. We only included patients receiving active aneurysm treatment. Favorable functional outcome, defined as a Glasgow Outcome Scale (GOS) of 4–5 at 12 months, was our primary outcome. We used logistic regression to compare prognostic factors between the groups. Results Ninety-five (85%) of 112 older patients and 317 (94%) of 336 younger patients received aneurysm treatment. Of the younger patients, 91% with a good-grade SAH (WFNS I-III) had a favorable outcome compared to 52% in the older good-grade SAH group. In poor-grade patients (WFNS IV-V), favorable outcome was seen in 51% of younger patients, compared to 24% of older patients. Acute hydrocephalus and intracerebral hemorrhage were associated with unfavorable outcome in the younger (OR 4.7, 95% CI 2.6–8.4, and OR 3.7, 95% CI 2.1–6.4), but not in the older patients (OR 1.8, 95% CI 0.8–4.2, and OR 1.3, 95% CI 0.5–3.1, respectively). Conclusions In actively treated SAH patients, age was a major determinant of outcome. Factors reflecting increases in intracranial pressure associated with outcome only among younger patients.

show abstract

Section: Comparison With Previous Literaturecontrasting

confidence: 57%

Neurointensive care results and risk factors for unfavorable outcome in aneurysmatic SAH: a comparison of two age groups

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Although ozagrel has been used in combination with statins in previous clinical studies[ 50 ], most studies assessed only blood glucose or a single blood index. We assessed blood glucose, blood lipids, blood coagulation, ESR, NIHSS score, ADL score, inflammatory factors, and specific indicators, namely, HMGB1, PON-1, and MIF in a comprehensive analysis; we found that the combination of these two drugs has a good effect on blood glucose and blood lipids, reduces nerve injury, and reduces inflammation.…”

Section: Discussionmentioning

confidence: 99%

Sodium ozagrel and atorvastatin for type 2 diabetes patients with lacunar cerebral infarction

Yu¹,

Wang²,

Zhu³

et al. 2021

WJD

View full text Add to dashboard Cite

BACKGROUND The main pathological factor of cerebral infarction is atherosclerosis, which is the pathological process of chronic inflammatory diseases such as vascular smooth muscle hyperplasia, inflammatory cell infiltration, extracellular matrix increase, and thrombosis. At present, the focus of clinical treatment is anti-platelet aggregation and improving blood status, and current research is limited to improving symptoms only. AIM To observe the effect of sodium ozagrel and atorvastatin on type 2 diabetes patients with lacunar cerebral infarction. METHODS Eighty-two patients with type 2 diabetes and lacunar cerebral infarction admitted to our hospital from January 2018 to February 2020 were equally categorized into two groups according to their treatment method. The control group was administered atorvastatin, and the observation group was administered sodium ozagrel combined with atorvastatin. The National Institutes of Health stroke scale (NIHSS) score, activities of daily living (ADL) score, blood glucose, lipid levels, inflammatory factors, high-mobility group box 1 (HMGB1) levels, paraoxonase-1 (PON-1) levels, erythrocyte sedimentation rate (ESR), and macrophage migration inhibitory factor (MIF) levels were recorded before and after treatment. The total effective rate and adverse reaction rate of the two groups were analyzed. RESULTS The total effective rate of the observation group (94.00%) was significantly higher than that of the control group (80.00%) ( χ 2 = 3.998; P = 0.046). The blood glucose indexes, total cholesterol levels, triglyceride levels, low-density lipoprotein cholesterol levels, high-sensitivity C-reactive protein levels, interleukin-1β levels, tumor necrosis factor-α levels, HMGB1 Levels, ESR, MIF levels, platelet aggregation rates, and plasma viscosity of the two groups decreased after treatment; however, high-density lipoprotein cholesterol and PON-1 Levels increased after treatment. After treatment, the blood glucose indexes; blood lipid indexes; inflammatory factors; HMGB1, PON-1, and MIF levels; ESR; platelet aggregation rate; and plasma viscosity of the observation group were better than those of the control group ( P < 0.05). After treatment, all patients in the observation group had higher ADL scores and lower NIHSS scores than those in the control group ( P < 0.05). CONCLUSION Sodium ozagrel with atorvastatin can reduce inflammatory reactions; regulate ESR and HMGB1, PON-1, and MIF levels; control blood glucose and lipid indexes; and alleviate nerve injury without increasing adverse effects of atorvastatin alone.

show abstract

“…Among the studies, 17 of 20 comparative studies and 28 of 39 regression-based studies were conducted in single centers (ESM Table S4). Seven regression-based studies collected data from a large number (i.e., > 30) of centers, including five post hoc analyses of the CONSCIOUS-1 trial [ 45 , 56 , 60 , 61 , 67 ] and two studies based in Japan [ 62 , 73 ].…”

Section: Resultsmentioning

confidence: 99%

Clinical Burden of Angiographic Vasospasm and Its Complications After Aneurysmal Subarachnoid Hemorrhage: A Systematic Review

Chalet

Briasoulis

Manalastas³

et al. 2023

Neurol Ther

View full text Add to dashboard Cite

Introduction: Angiographic vasospasm (VSP), the narrowing of intracranial arteries, is a complication of aneurysmal subarachnoid hemorrhage (aSAH) and often results in delayed cerebral ischemia (DCI) and cerebral infarction. The objective of this systematic review was to summarize the clinical burden of angiographic VSP and its related complications (DCI and cerebral infarction) after aSAH. Methods: Systematic searches of MEDLINE, Embase, and the Cochrane Library were conducted (in January 2021) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies reporting clinical outcomes of angiographic VSP and its related complications after aSAH. Study outcomes included

show abstract

Effect of treatment modality and cerebral vasospasm agent on patient outcomes after aneurysmal subarachnoid hemorrhage in the elderly aged 75 years and older

Cited by 25 publications

References 45 publications

Neurointensive care results and risk factors for unfavorable outcome in aneurysmatic SAH: a comparison of two age groups

Neurointensive care results and risk factors for unfavorable outcome in aneurysmatic SAH: a comparison of two age groups

Sodium ozagrel and atorvastatin for type 2 diabetes patients with lacunar cerebral infarction

Clinical Burden of Angiographic Vasospasm and Its Complications After Aneurysmal Subarachnoid Hemorrhage: A Systematic Review

Contact Info

Product

Resources

About