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Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms

BACKGROUND AND AIM: Subarachnoid haemorrhage (SAH) patients have an excess mortality proportion in long-term outcome studies because of the high rate of cerebrovascular and cardiovascular deaths. The aim of the present study was to assess the excess long-term mortality among patients with unruptured...

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Autores principales: Pyysalo, Liisa, Luostarinen, Tapio, Keski-Nisula, Leo, Öhman, Juha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717756/
https://www.ncbi.nlm.nih.gov/pubmed/23424191
http://dx.doi.org/10.1136/jnnp-2012-303073
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author Pyysalo, Liisa
Luostarinen, Tapio
Keski-Nisula, Leo
Öhman, Juha
author_facet Pyysalo, Liisa
Luostarinen, Tapio
Keski-Nisula, Leo
Öhman, Juha
author_sort Pyysalo, Liisa
collection PubMed
description BACKGROUND AND AIM: Subarachnoid haemorrhage (SAH) patients have an excess mortality proportion in long-term outcome studies because of the high rate of cerebrovascular and cardiovascular deaths. The aim of the present study was to assess the excess long-term mortality among patients with unruptured aneurysms with no previous SAH and to compare excess mortality after coiling, clipping and without treatment. METHODS: Between 1989 and 1999, a total of 1294 patients with intracranial aneurysms were admitted to our hospital. Of these, 1154 had previous SAH and were excluded leaving 140 patients with 178 intracranial unruptured aneurysms as the study population. The patients were followed up until death or by the end of April 2011. Causes of death were determined. Relative survival ratios (RSRs) were calculated and compared with the matched general population. RESULTS: Mean follow-up time was 13 years (range 1–19). During the follow-up period, 36% of patients died. Death was caused by cerebrovascular event in half of the cases. There were 12% excess mortality at 15 years in men and 35% excess mortality in women compared with general population. Excess mortality among women over 50 years was significantly higher than that among men (p=0.018). CONCLUSIONS: Patients with untreated unruptured aneurysms have 50% excess long-term mortality compared with general population. Men with treated unruptured aneurysms have a survival proportion comparable with matched general population. Women, instead, have 28% excess mortality after surgical treatment and 23% excess mortality after endovascular treatment of unruptured aneurysms.
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spelling pubmed-37177562013-07-23 Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms Pyysalo, Liisa Luostarinen, Tapio Keski-Nisula, Leo Öhman, Juha J Neurol Neurosurg Psychiatry Cerebrovascular Disease BACKGROUND AND AIM: Subarachnoid haemorrhage (SAH) patients have an excess mortality proportion in long-term outcome studies because of the high rate of cerebrovascular and cardiovascular deaths. The aim of the present study was to assess the excess long-term mortality among patients with unruptured aneurysms with no previous SAH and to compare excess mortality after coiling, clipping and without treatment. METHODS: Between 1989 and 1999, a total of 1294 patients with intracranial aneurysms were admitted to our hospital. Of these, 1154 had previous SAH and were excluded leaving 140 patients with 178 intracranial unruptured aneurysms as the study population. The patients were followed up until death or by the end of April 2011. Causes of death were determined. Relative survival ratios (RSRs) were calculated and compared with the matched general population. RESULTS: Mean follow-up time was 13 years (range 1–19). During the follow-up period, 36% of patients died. Death was caused by cerebrovascular event in half of the cases. There were 12% excess mortality at 15 years in men and 35% excess mortality in women compared with general population. Excess mortality among women over 50 years was significantly higher than that among men (p=0.018). CONCLUSIONS: Patients with untreated unruptured aneurysms have 50% excess long-term mortality compared with general population. Men with treated unruptured aneurysms have a survival proportion comparable with matched general population. Women, instead, have 28% excess mortality after surgical treatment and 23% excess mortality after endovascular treatment of unruptured aneurysms. BMJ Publishing Group 2013-08 2013-02-19 /pmc/articles/PMC3717756/ /pubmed/23424191 http://dx.doi.org/10.1136/jnnp-2012-303073 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Cerebrovascular Disease
Pyysalo, Liisa
Luostarinen, Tapio
Keski-Nisula, Leo
Öhman, Juha
Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title_full Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title_fullStr Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title_full_unstemmed Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title_short Long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
title_sort long-term excess mortality of patients with treated and untreated unruptured intracranial aneurysms
topic Cerebrovascular Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717756/
https://www.ncbi.nlm.nih.gov/pubmed/23424191
http://dx.doi.org/10.1136/jnnp-2012-303073
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