901 Management, Complications and Neurological Outcomes of Aneurysmal Subarachnoid Haemorrhage in Elderly Patients

Aim To study the management of aneurysmal subarachnoid haemorrhage (aSAH) and compare neurological outcomes in different elderly age groups. Method A retrospective cohort study. aSAH patients with age 60 and above admitted to Royal Victoria Hospital Belfast between 2015 to 2019 were enrolled, and divided into 3 sub-groups, age 60 – 69 (Group I), age 70 – 79 (Group II) and age >80 (Group III). Patient characteristics and clinical courses were compared, including co-morbidities, WFNS grades, interventions, complications and neurological outcomes at follow up. Results 158 patients were included, with 104 in Group I, 49 in Group II and 5 in Group III. Despite Group III patients presented with only WFNS grade 1 & 2, mortality increased exponentially with age from 9.6% to 12.2% to 40% across 3 sub-groups. There was also a linear increase in average length of stay (LOS) from 21 to 24 days. 81 Group I patients (77.9%) developed complications and 38 patients (77.6%) in Group II. In Group III, 3 patients (60%) developed complications when 2 other patients did not survive. Most common complications were hydrocephalus (46.2%) and hospital acquired infections 36.7%). Conclusions Our study suggests patients with age >80 had less favourable neurological outcomes despite having low grade aSAH at presentation and received similar intervention. Average LOS in hospital also increased with age. Similar complication rates were noticed in all groups. Comparing our data with other neurosurgical units in UK and Ireland will provide further information in managing elderly aSAH patients and facilitate risk stratification when considering those patients for intervention.