Premium
Prognostic factors for cerebral infraction and outcome in patients with intracranial aneurysm
Author(s) -
Zhu Yuan,
Zhao Hongyang,
Zhu Xianli
Publication year - 2012
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2012.00599.x
Subject(s) - medicine , clipping (morphology) , aneurysm , endovascular coiling , subarachnoid hemorrhage , diabetes mellitus , modified rankin scale , surgery , logistic regression , endovascular treatment , philosophy , linguistics , ischemic stroke , ischemia , endocrinology
Aim The purpose of this study was to describe prognostic factors for cerebral infraction and outcome in patients undergoing neurosurgical clipping or endovascular coiling with intracranial aneurysms. In addition, we compared the incidence of cerebral infraction and outcome in patients treated with neurosurgical clipping or endovascular coiling. Patients and Methods Data were analysed from 972 patients with intracranial aneurysms enrolled at U nion H ospital between S eptember 2007 and M ay 2011. Multivariable logistic regression with backwards selection were derived to define independent predictors of cerebral infraction and outcome in patients undergoing neurosurgical clipping or endovascular coiling of intracranial aneurysms. Results In the multivariable analysis, cerebral infraction was not associated with the history of hypertension, smoking, diabetes mellitus, aneurysmal size and number, the use of dehydrant and low‐dosage i.v. nimodipine. Factors that contributed most to variation in cerebral infraction, in descending order of importance, were Fisher grade of the computed tomography scan, aneurysmal location, Hunt and Hess scale grade on admission, rupture times, the operating day from first rupture, increasing age, treatment modality and male sex. Predictors of poor outcome, also in descending order of importance, were Hunt and Hess scale grade IV, rupture one to three times, cerebral infraction, Fisher grade 3, operation on 4th−14th day from rupture, diabetes mellitus history, age > 55 years, hypertension history, smoking history and neurosurgical clipping. Conclusion Although most prognostic factors for cerebral infraction and outcome after subarachnoid haemorrhage are already present on admission, for suitable patients endovascular coiling and early intervention are recommended.