Risk Factor for Poor Outcome in Elderly Patients with Aneurysmal Subarachnoid Hemorrhage Based on Post Hoc Analysis of the Modified WFNS Scale Study

Ozono, Iori; Ikawa, Fusao; Hidaka, Toshikazu; Yoshiyama, Michitsura; Matsuda, Shingo; Michihata, Nobuaki; Kobata, Hitoshi; Murayama, Yuichi; Sato, Akira; Kato, Yoshihiro; Sano, Hirotoshi; Yamaguchi, Shûhei; Kurisu, Kaoru

doi:10.1016/j.wneu.2020.05.196

Cited by 11 publications

(12 citation statements)

References 15 publications

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“…The study included consecutive patients with a diagnosis of aSAH admitted to participating hospitals between April 2014 and March 2019, all of whom had undergone physical therapy with/without occupational therapy. The exclusion criteria were as follows: (1) patients who had died, (2) those without aneurysm treatment, (3) those with a recurrence of aSAH, (4) those who had undergone reoperation, (5) those who underwent aneurysm treatment >72 hours after the onset of aSAH, (6) those who were <20 years old, (7) those diagnosed with SCV before initiating mobilization, and (8) those for whom data were lacking. The included patients were divided into the SCV group (diagnosed) and the non-SCV group (no SCV present).…”

Section: Participantsmentioning

confidence: 99%

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Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

et al. 2022

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The study aim was to investigate the association between initiating mobilization within 7 days after onset and symptomatic cerebral vasospasm (SCV) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: This was a retrospective multicenter case-control study in Japan. Patients with a diagnosis of aSAH who underwent physical therapy with/without occupational therapy were included and categorized into 2 groups according to the presence or absence of SCV. Initiating mobilization was defined as sitting on the bed edge (at least once, with/without assist, regardless of duration) within 7 days after aSAH onset. Cox proportional hazards regression analysis was performed to evaluate the association between initiating mobilization within 7 days after onset and SCV. Results: The analysis included 510 patients. Among all included patients, 57 (11.2%) patients had SCV. In the univariate Cox proportional hazards regression analysis, initiating of mobilization was not associated with SCV (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.45-1.32). In the multivariate analysis, only the modified Fisher scale was significantly associated with SCV (HR = 26.23; 95% CI = 1.21-571.0). Conclusion: Initiating mobilization within 7 days after aSAH onset was not associated with SCV in patients with aSAH.

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Section: Participantsmentioning

confidence: 99%

“…Therefore, treatment after aSAH is very complicated and difficult [2][3][4] . Among the potential complications, SCV is strongly associated with poor functional outcome and mortality [5][6][7] . SCV is observed in approximately 20%−30% of patients with aSAH [8][9][10] .…”

mentioning

confidence: 99%

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

et al. 2022

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“…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%

“…Three [ 26 , 29 , 39 ] of nine comparative studies and 11 [ 48 , 49 , 52 – 54 , 60 , 63 , 65 , 71 , 73 , 74 ] of 13 regression-based studies found that patients with angiographic VSP or VSP-related complications have significantly poorer functional outcomes, as measured by the mRS, both at discharge and follow-up, than patients without angiographic VSP or VSP-related complications. In six studies [ 33 , 38 , 44 , 59 , 66 , 76 ] that looked at specific VSP populations (e.g., by severity or timing of angiographic VSP, TCD-defined VSP or cerebral VSP), the outcomes were mixed.…”

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

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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

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“…The details of data collection and management have been published elsewhere. [17,22] All patients were aged ≥ 15 years, and the interval between onset and admission was ≤ 72 hours in this cohort. Age was classi ed as follows: non-elderly (NE), < 65 years; pre-elderly (PE), 65-74 years; and elderly (E), ≥ 75 years; according to the classi cation of the World Health Organization and the Japan Geriatrics Society.…”

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confidence: 99%

Impact of Age On Short-Term Outcomes After Discharge in Patients With Aneurysmal Subarachnoid Hemorrhage

Hosogai¹,

Ikawa²,

Hidaka³

et al. 2021

Preprint

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Changes in outcome after discharge of patients with aneurysmal subarachnoid hemorrhage (aSAH) have not been examined in detail in recent aging society. This study aimed to clarify the prevalence and factors of changes in outcome in these patients based on a registry database in Japan. Overall, 1,111 radically treated patients with aSAH in the acute stage were selected between January 2010 and December 2012 for inclusion in the modified World Federation of Neurosurgical Societies (mWFNS) scale study. The modified Rankin Scale (mRS) score at discharge and 3 months after onset, prevalence of improvement and decline between these two periods, and their factors were evaluated by age groups through multivariate logistic regression analysis. The rates of improvement and decline were 28.4% and 2.4%, respectively. Factors that improved the mRS score were WFNS and mWFNS scale grade Ⅳ versus (vs.) Ⅰ (odds ratio: 0.47, 95% confidence interval: 0.31–0.71), grade Ⅴ vs. Ⅰ (0.49, 0.31–0.76), and cerebral vasospasm category 4 vs. 1 (0.43, 0.25–0.77). Factors that decreased the mRS score were pre-elderly (65–74 years) vs. non-elderly (<65 years) (5.65, 1.09–29.20), elderly (≥75 years) vs. non-elderly (19.20, 2.36–156.50), WFNS scale grade III vs. I, and aneurysmal location. Mild neurological grade on admission and no cerebral infarction due to cerebral vasospasm were the factors improving outcomes, and aging was a factor declining outcomes between discharge and at 3 months after onset. Careful assessment timing of outcome in elderly patients is needed in the future aging society.

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Risk Factor for Poor Outcome in Elderly Patients with Aneurysmal Subarachnoid Hemorrhage Based on Post Hoc Analysis of the Modified WFNS Scale Study

Cited by 11 publications

References 15 publications

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

Initiating Mobilization Is Not Associated with Symptomatic Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Case-control Study

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

Impact of Age On Short-Term Outcomes After Discharge in Patients With Aneurysmal Subarachnoid Hemorrhage

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