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Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage
OBJECTIVE: The influence of preexisting factors on the clinical course of patients with subarachnoid hemorrhage (SAH), such as patient age, arterial hypertension, and aneurysm characteristics, is still a matter of debate. However, the specific impact of the exact aneurysm location has not received a...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964037/ https://www.ncbi.nlm.nih.gov/pubmed/35359650 http://dx.doi.org/10.3389/fneur.2022.846066 |
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author | Göttsche, Jennifer Piffko, Andras Pantel, Tobias F. Westphal, Manfred Dührsen, Lasse Czorlich, Patrick Sauvigny, Thomas |
author_facet | Göttsche, Jennifer Piffko, Andras Pantel, Tobias F. Westphal, Manfred Dührsen, Lasse Czorlich, Patrick Sauvigny, Thomas |
author_sort | Göttsche, Jennifer |
collection | PubMed |
description | OBJECTIVE: The influence of preexisting factors on the clinical course of patients with subarachnoid hemorrhage (SAH), such as patient age, arterial hypertension, and aneurysm characteristics, is still a matter of debate. However, the specific impact of the exact aneurysm location has not received adequate attention. Therefore, the aim of this study was to investigate the influence of aneurysm location as a preexisting factor on the clinical course and mortality. METHODS: The data of consecutive patients with aneurysmal SAH who were treated from October 2010 to July 2020 were retrospectively analyzed. We distinguished four aneurysm locations: the anterior complex, internal carotid artery (ICA), middle cerebral artery (MCA), and posterior circulation. Logistic regression analysis and receiver operating characteristics were used to investigate the influence of aneurysm location on the occurrence of acute hydrocephalus, Delayed Cerebral Ischemia (DCI), neurological outcome, and in-hospital mortality. Neurological outcome was assessed 3 months after discharge using the Glasgow Outcome Scale. RESULTS: A total of 603 patients were included in this study. Patients with MCA aneurysms were 2.52 times less likely to develop acute hydrocephalus compared to patients with anterior complex aneurysms (p = 0.001). Delayed cerebral ischemia occurred most frequently in patients with an anterior complex aneurysm and least frequently in MCA aneurysms (p = 0.014). In ICA aneurysms, mortality was 2.56-fold higher than in patients with aneurysms of the anterior complex (p = 0.006). An additional ROC analysis showed a good prediction for in-hospital mortality when taking the aneurysm's location into account [AUC.855 (CI.817 −0.893)]. CONCLUSIONS: The aneurysm's location proved to be a significant predictor of acute hydrocephalus, DCI, and in-hospital mortality, demonstrating the impact of this preexisting biological factor on the course of SAH. |
format | Online Article Text |
id | pubmed-8964037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89640372022-03-30 Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage Göttsche, Jennifer Piffko, Andras Pantel, Tobias F. Westphal, Manfred Dührsen, Lasse Czorlich, Patrick Sauvigny, Thomas Front Neurol Neurology OBJECTIVE: The influence of preexisting factors on the clinical course of patients with subarachnoid hemorrhage (SAH), such as patient age, arterial hypertension, and aneurysm characteristics, is still a matter of debate. However, the specific impact of the exact aneurysm location has not received adequate attention. Therefore, the aim of this study was to investigate the influence of aneurysm location as a preexisting factor on the clinical course and mortality. METHODS: The data of consecutive patients with aneurysmal SAH who were treated from October 2010 to July 2020 were retrospectively analyzed. We distinguished four aneurysm locations: the anterior complex, internal carotid artery (ICA), middle cerebral artery (MCA), and posterior circulation. Logistic regression analysis and receiver operating characteristics were used to investigate the influence of aneurysm location on the occurrence of acute hydrocephalus, Delayed Cerebral Ischemia (DCI), neurological outcome, and in-hospital mortality. Neurological outcome was assessed 3 months after discharge using the Glasgow Outcome Scale. RESULTS: A total of 603 patients were included in this study. Patients with MCA aneurysms were 2.52 times less likely to develop acute hydrocephalus compared to patients with anterior complex aneurysms (p = 0.001). Delayed cerebral ischemia occurred most frequently in patients with an anterior complex aneurysm and least frequently in MCA aneurysms (p = 0.014). In ICA aneurysms, mortality was 2.56-fold higher than in patients with aneurysms of the anterior complex (p = 0.006). An additional ROC analysis showed a good prediction for in-hospital mortality when taking the aneurysm's location into account [AUC.855 (CI.817 −0.893)]. CONCLUSIONS: The aneurysm's location proved to be a significant predictor of acute hydrocephalus, DCI, and in-hospital mortality, demonstrating the impact of this preexisting biological factor on the course of SAH. Frontiers Media S.A. 2022-03-14 /pmc/articles/PMC8964037/ /pubmed/35359650 http://dx.doi.org/10.3389/fneur.2022.846066 Text en Copyright © 2022 Göttsche, Piffko, Pantel, Westphal, Dührsen, Czorlich and Sauvigny. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Göttsche, Jennifer Piffko, Andras Pantel, Tobias F. Westphal, Manfred Dührsen, Lasse Czorlich, Patrick Sauvigny, Thomas Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title | Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title_full | Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title_fullStr | Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title_full_unstemmed | Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title_short | Aneurysm Location Affects Clinical Course and Mortality in Patients With Subarachnoid Hemorrhage |
title_sort | aneurysm location affects clinical course and mortality in patients with subarachnoid hemorrhage |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964037/ https://www.ncbi.nlm.nih.gov/pubmed/35359650 http://dx.doi.org/10.3389/fneur.2022.846066 |
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