Abstract
Objective To identify the predictors of outcomes in elderly patients undergoing coiling of ruptured cerebral aneurysms. Methods Ninety consecutive elderly patients (≥60 years)with ruptured aneurysms underwent coiling between January 2012 and November 2013. The potential factors for unfavorable outcome were evaluated by a univariate analysis and multivariate Logistic regression analysis. The outcome was measured by the modified Rankin scale (mRs) and was dichotomized into favorable (mRs 0-2) and unfavorable (3-6). The median follow-up was 10.6 months(range, 1-22 months). Results Among the 90 patients, 77 (86%)patients had a favorable outcome. Thirteen patients(14%) had an unfavorable outcome. Seventy-two (91%)of 79 patients with World Federation of Neurosurgical Societies (WFNS) grade Ⅰ-Ⅲ had a favorable outcome. Five (45%)of 11 Patients with WFNS grade Ⅳ-Ⅴ had a favorable outcome. And 2 (3%)of 61 Patients with Fisher grade 1-2 showed the poor clinical recovery, whereas 11(38%)of 29 Patients with Fisher grade 3-4 showed the poor clinical recovery. Six(55%)of 11 Patients with shunt-dependent hydrocephalus had unfavorable outcome. Univariate analysis revealed that age, Ⅳ-Ⅴ WFNS grade, 3-4 Fisher grading, shunt-dependent hydrocephalus, in-hospital complication were potential predictors for poor outcome(mRs 3-6)(P<0.05). Multivariate Logistic regression analysis showed that 3-4 Fisher grading (OR=10.4671, P<0.05) and shunt-dependent hydrocephalus (OR=19.978, P<0.05) were independent risk factors for for poor outcome after endovascular treatment of ruptured cerebral aneurysms. Conclusions Fisher grade 3-4, shunt-dependent hydrocephalus were independent predictors of unfavorable outcomes in elderly patients undergoing coiling of ruptured cerebral aneurysms. Key words: Aged; Intracranial aneurysm; Subarachnoid hemorrhage; Embolization, therapeutic; Risk factors; Prognosis
Published Version
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