Prognostic factors for adult patients with hemorrhagic moyamoya disease in the acute stage

Abstract

ObjectivesHemorrhagic moyamoya disease (MMD) is one common subtype in adult patients. However, the study about outcome of hemorrhagic MMD patients in the acute stage is still lacking. This study is aimed to explore the short-term prognostic factors for adult patients with hemorrhagic MMD in the acute stage. Patients and MethodsAdult hemorrhagic MMD patients in the acute stage awere retrospectively analyzed. Both clinical and imaging data were collected. Unfavorable functional outcome at discharge was considered when modified Rankin Scale score ≥3. Multivariate logistic regression was used to investigate the prognostic factors in patients with hemorrhagic MMD in the acute stage. ResultsA total of 107 patients were included in this study. Among these patients, 17 died and 59 had unfavorable functional outcome at 9.6 ± 7.8 days. In multivariate logistic regression, admission blood glucose (odds ratio (OR) = 1.457, 95% confidence interval (CI) 1.156–1.836, P = 0.001), midline shift >5 mm (OR = 24.268, 95%CI 4.324–136.191, P < 0.001), and subarachnoid hemorrhage (OR = 13.067, 95%CI 2.020–84.512, P = 0.007) were independently associated with death at discharge. Moreover, admission Glasgow Coma Scale (GCS) score (OR = 0.420, 95%CI 0.296–0.598, P < 0.001), midline shift >5 mm (OR = 6.685, 95%CI 1.226–36.455, P = 0.028), and intraparenchymal hemorrhage (OR = 4.790, 95%CI 1.184–19.381, P = 0.028) were independently associated with unfavorable functional outcome at discharge. ConclusionThis study shows that admission blood glucose, midline shift >5 mm, and subarachnoid hemorrhage are independent predictors of short-term mortality in hemorrhagic MMD in the acute stage. In addition, admission GCS score, midline shift >5 mm, and intraparenchymal hemorrhage are independent predictors of short-term unfavorable functional outcome in hemorrhagic MMD in the acute stage.