Long-term Functional Outcome In Patients Research Articles

High patient satisfaction and good long-term functional outcome after endoscopic calcaneoplasty in patients with retrocalcaneal bursitis

PurposeThe primary objective of this study was to determine the degree of patient satisfaction at a minimum of 5 years of follow-up after endoscopic calcaneoplasty. The secondary objectives were to assess functional outcome measures, pain scores, analysis of bone removal, reformation of exostosis at follow-up and correlation of the size of the exostosis and recurrent or persisting complaints.MethodsThis study evaluated patients who underwent endoscopic calcaneoplasty, between January 1st 2000 and December 31st 2010, for the diagnosis of retrocalcaneal bursitis. The evaluation consisted of PROMs (patient-reported outcome measures), a questionnaire and a visit to the outpatient clinic for physical examination and a standard lateral weight-bearing radiograph of the ankle. Patient satisfaction, functional outcomes and pain scores were measured by use of a numeric rating scale (NRS). Size of the posterosuperior calcaneal exostosis was measured on a standard lateral weight-bearing radiograph using parallel pitch lines (PPL) and the Fowler–Philip angle (PFA).ResultsThe response rate was 28 out of 55 (51%) and the median time to follow-up was 101(IQR 88.5–131.8) months. The median satisfaction score for treatment results was 8.5 out of 10 (IQR 6–10). FAOS symptoms 84.5 (IQR 58.0–96.4), FAOS pain 90.3 (IQR 45.1–100.0), FAOS ADL 94.9 (IQR 58.1–100.0), FAOS sport 90.0 (IQR 36.3–100.0) and FAOS QOL 71.9 (IQR 37.5–93.8) and median AOFAS was 100 (IQR 89–100). The median PLL difference between before operation and 2 weeks after the operation was − 4 mm (IQR-6 and -1) and the median PLL difference between 2 weeks after the operation and at follow-up was 1 mm (0–2). The median PFA was 65 (63–69) at baseline, 66.5 (60.8–70.3) 2 weeks after the operation and 64 (60.8–65.3) at follow-up.ConclusionDespite the limited response rate, this study shows high patient satisfaction and good long-term functional outcome in patients affected by retrocalcaneal bursitis who underwent endoscopic calcaneoplasty.Level of evidenceLevel IV.

Outcomes Following Mangling Upper Extremity Trauma

Mangling injuries involve multiple tissue types and present a challenge for reconstructive surgeons. While multiple reconstructive techniques have been described for bones, vessels, nerves, and soft tissues, there are few studies examining the long-term functional outcomes of patients with mangled upper extremities. As a result, there are few evidence-based management paradigms to improve functional outcomes. This paper is a review of the literature throughout the past decade on the management of upper extremity trauma, with seven studies focused on long-term functional outcome measures. While there is little consensus in the medical literature on the preferred functional outcome measure for upper extremity trauma, even patients with the most severe injuries can achieve a reasonable functional outcome, with the ability to maintain employment and perform basic functions of daily living with their injured limb.

The association between hyponatraemia and long-term functional outcome in patients with aneurysmal subarachnoid haemorrhage: A single centre prospective cohort study

To assess the association between hyponatraemia and long-term functional outcome and other relevant outcomes in patients with aneurysmal subarachnoid haemorrhage (aSAH) we conducted a prospective cohort study in a Neurosciences Intensive Care Unit (ICU) in Sydney, Australia. The primary exposure variable was hyponatraemia (Na+ <135 mmol/L). The primary outcome was favourable outcome, a score of 5–8 on the extended Glasgow Outcome Score (GOSe) at 12 months. We also measured mortality, the incidence of delayed cerebral ischaemia (DCI) and cerebral arterial vasospasm and duration of ICU and hospital admission. There were 200 participants, 111 (56%) developed hyponatraemia. Hyponatraemia was not associated with favourable outcome at 12 months (unadjusted odds ratio [OR] OR 1.31, 95% confidence interval [CI] 0.65–2.65, p = 0.56). The result was similar after adjustment for baseline covariates (adjusted OR 0.60, 95% CI 0.16–1.99, p = 0.43). There was no association between hyponatraemia and the incidence of DCI (OR 0.95, 95% CI 0.46 to 2.0, p > 0.99) nor cerebral arterial vasospasm (OR 1.4, 95% CI 0.8 to 2.5, p = 0.27). Those who developed hyponatraemia had a longer median duration of ICU admission (17 days, interquartile range [IQR] 12 to 20, compared to 13 days, IQR 8–21, p = 0.02) and longer median duration of hospital admission (24 days, IQR 21–30, compared to 22 days IQR 14–31, p = 0.05). While hyponatraemia is common following aSAH, it is not associated with worse long-term functional outcome, increased rate of DCI, nor cerebral arterial vasospasm. Hyponatraemia in patients with aSAH was associated with longer duration of ICU and hospital admission.

828 - Does 5-alpha reductase inhibitor intake impact procedural efficacy, short- and long-term functional outcomes in patients undergoing Holmium Laser Enucleation of the Prostate (HoLEP)? A retrospective single-center analysis among 1,360 patients

828 - Does 5-alpha reductase inhibitor intake impact procedural efficacy, short- and long-term functional outcomes in patients undergoing Holmium Laser Enucleation of the Prostate (HoLEP)? A retrospective single-center analysis among 1,360 patients

The Impact of the Ligamentous Injury Pattern and Associated Neurovascular Injury on Ultimate Knee Function in Patients with Traumatic Knee Dislocations.

The present study aims to investigate whether there is a relationship between the ligamentous injury pattern and concomitant neurovascular injury with long-term functional outcomes in patients with traumatic knee dislocations (TKDs). A total of 42 patients with TKDs were categorized according to the Schenck's classification based on the pattern of ligamentous injury. Concomitant vascular and neural injuries were recorded. Long-term functional outcomes were assessed using several objective and subjective outcome measures. This retrospective study was conducted in two phases: (1) to analyze the impact of ligamentous injury pattern on functional outcomes of patients with TKDs in the overall study population, by comparing all the variables among Schenck's grades; (2) to determine the impact of concomitant vascular and neural injury on ultimate knee function based on the subgroup analyses. In the overall study statistical differences were determined among each pattern of ligamentous injury in the total range of motion (ROM) and scoring systems (chi-squared test, p = 0.254). The overall rates of vascular and neural injury were 26 and 28%, respectively. In subgroup analyses, 40 patients were divided into three subgroups: group A (isolated concomitant neural injury), group B (isolated concomitant vascular injury), group C (without concomitant major vascular or neural injury). The analysis revealed a significant difference in the total ROM (p = 0.005), flexion measurements (p = 0.004), and the loss of extension (p = 0.003). Group A had the lowest total knee ROM and the mean flexion degrees, as well as the highest loss of extension. Concerning functional scoring systems including the combined Knee Society Score (knee score + function score), Lysholm knee scoring scale, and International Knee Documentation Committee score, subgroup analyses revealed significant differences among the groups (p = 0.001, p < 0.01 for all scores). All the scores were found to be lowest in group A. Evidence from the current study showed that the ligamentous pattern and concomitant neurovascular injury both may have a significant impact on ultimate knee function in patients with TKDs. This is a Level III-retrospective comparative study.

Accuracy in prediction of long-term functional outcome in patients with traumatic axonal injury: a comparison of MRI scales

ABSTRACTPurpose: Functional outcome prediction for patients with traumatic axonal injury (TAI) is not highly related to the MRI classifications. The aim of this study was to assess the accuracy in predicting functional outcome in patients with TAI with several MRI scoring methods and to define the most accurate method.Methods: Patients with TAI (2008–2014) confirmed on MRI <6 months after injury were included in this retrospective study. Long-term functional outcome was prospectively assessed using the Glasgow Outcome Score Extended. The Gentry classification is most used in clinical practice. This method was compared to methods that score lesion load, lesion locations, and to modified Gentry classifications. The area under the curve (AUC) was calculated for the scoring methods.Results: A total of 124 patients with TAI were included, medium follow-up 52 months. The AUC for the Gentry classification was 0.64. All tested methods were poor predictors for functional outcome, except for the 6-location score (area under the curve: 0.71). No method was significantly better than the Gentry classification.Conclusion: The Gentry classification for TAI correlates with functional outcome, but is a poor predictor for the long-term functional outcome. None of the other tested methods was significantly better.

Radiotherapy Does Not Impact Long-term Function Following Resection of Soft-tissue Sarcomas of the Hand.

Radiotherapy for soft tissue sarcomas (STS) of the hand is thought to be associated with poor function. The aim of this study was to compare the long-term functional outcome in patients with and without radiotherapy. At long-term follow-up (mean 10±5 years), 33 (13 males, 20 female) patients, were alive for review. The mean patient age at surgery was 33±17 years and 13 (39%) patients received radiotherapy (mean dose 55±6 Gy). Postoperatively, the mean QuickDASH and MSTS93 were 7±8 and 92±8%, respectively. Comparing patients with and without radiotherapy, there was no difference (p>0.05) between the mean QuickDASH (5±5 vs. 8±9) or MSTS93 (93±9% vs. 91±8%). Surgical complication occurred more commonly in patients with radiotherapy (46% vs. 15%, p=0.10). The use of radiotherapy was associated with a higher rate of complications, however, was not associated with a worse long-term functional outcome in patients with hand STS.

Abstract TP36: Impact of Intracranial Hemorrhage After Endovascular Treatment on Long-Term Functional Outcomes in Patients With Acute Large Vessel Occlusion: Insights From RESCUE- Japan Registry-2

Background and Purpose: Endovascular therapy (EVT) for acute large vessel occlusion (LVO) is currently standard therapy, but it was associated with a higher incidence of intracranial hemorrhage (ICH) compared to conservative therapy. We investigated the impact of ICH within 72 hours on functional outcome at 90 days in patients with EVT for acute LVO. Methods: RESCUE-Japan Registry-2 was a multicenter registry enrolled 2420 consecutive patients with acute LVO within 24 hours of onset. We analyzed patients who received EVT and compared the functional outcomes between those with ICH (ICH group) and without ICH (No-ICH group) within 72 hours after onset. We estimated the adjusted odds ratio (OR) for good functional outcome as mRS 0-2 and mortality. We also explored the prognostic impact of symptomatic ICH (SICH) among those with ICH. Results: Among 2420 patients in the registry, 1281 received EVT and mean age was 75 years, and 759 (59.2%) were men. ICH occurred in 332 patients (25.9%). Good outcome was observed 80 patients (24.0%) and 454 patients (47.9%) in the ICH and No-ICH group, respectively, and the adjusted OR for good outcome of ICH group compared to No-ICH group was 0.30 (95% CI 0.22-0.42, p&lt;0.0001). However, the mortalities within 90 days were not significantly different between groups (adjusted OR 1.13; 95% CI 0.72-1.76, p=0.59). SICH was observed in 35 patients (10.5%) among 332 patients with ICH, and the good outcomes were 8.6% and 25.9 % in patients with SICH and asymptomatic ICH (AICH), respectively (p=0.02). Mortality at 90 days were 31.4% and 7.0% in patients with SICH and AICH, respectively (p&lt;0.0001). Conclusion: The functional outcomes at 90 days after onset was significantly worse in patients suffered ICH than the counterparts after EVT for acute LVO. However, the mortality rates were generally similar between those with and without ICH. Among patients with ICH, mortality was higher in patients with SICH, but mortality of the patients with AICH was similar to those without ICH.

Long-term Outcomes of Critically Ill Patients With Stroke Requiring Mechanical Ventilation.

Data on outcomes of critically ill patients requiring mechanical ventilation at the onset of stroke are limited. To assess the hospital and long-term functional outcomes of patients with stroke who require mechanical ventilation. This retrospective single-center cohort study performed from 1994 to 2008 involved adult patients within 7 days of stroke onset and who required intensive care unit admission and mechanical ventilation. A total of 274 patients requiring mechanical ventilation at the onset of stroke were analyzed. Indications for intubation included coma in 195 patients (71%). The median (interquartile range) score on the Glasgow Coma Scale at admission to the intensive care unit was 6 (3-9). Forty-four patients (16%) had sepsis at intensive care unit admission. The overall hospital mortality rate was 53%. After adjustment for confounders, severity of illness at admission as assessed by the Simplified Acute Physiology Score II (odds ratio, 1.07; 95% CI, 1.05-1.10), anisocoria (odds ratio, 5.26; 95% CI, 1.76-15.80), and sepsis at intensive care unit admission (odds ratio, 0.40; 95% CI, 0.19-0.85) were associated with outcome. At 1 year, median (interquartile range) modified Rankin Scale score was 6 (2-6). Only 89 patients (32%) exhibited mild to moderate neurologic impairment. In this study, adult patients requiring mechanical ventilation at the onset of stroke experienced high 1-year mortality, with survivors having poor functional status.

Outcomes of interfacility helicopter transportation in acute stroke care.

To evaluate the long-term functional outcome of interhospital transfer of patients with stroke with suspected large vessel occlusion (LVO) using Helicopter Emergency Medical Services (HEMS). Records of consecutive patients evaluated through 2 telestroke networks and transferred to thrombectomy-capable stroke centers between March 2017 and March 2018 were reviewed. Inverse probability of treatment weighting (IPTW) using the propensity score was performed to address confounding factors. Multivariate logistic regression analysis with IPTW was used to determine whether HEMS were associated with good long-term functional outcome (modified Rankin scale score ≤ 2). A total of 199 patients were included; median age was 67 years (interquartile range [IQR] 55-79 years), 90 (45.2%) were female, 120 (60.3%) were white, and 100 (50.3%) were transferred by HEMS. No significant differences between the 2 groups were found in mean age, sex, race, IV tissue plasminogen activator (tPA) receipt, and thrombectomy receipt. The median baseline NIH Stroke Scale score was 14 (IQR 9-18) in the helicopter group vs 11 (IQR 6-18) for patients transferred by ground (p = 0.039). The median transportation time was 60 minutes (IQR 49-70 minutes) by HEMS and 84 minutes (IQR 25-102 minutes) by ground (p < 0.001). After weighting baseline characteristics, the use of HEMS was associated with higher odds of good long-term outcome (OR 4.738, 95% CI 2.15-10.444, p < 0.001) controlling for transportation time, door-in-door-out time, and thrombectomy and tPA receipt. The magnitude of the HEMS effect was larger in thrombectomy patients who had successful recanalization (OR 1.758, 95% CI 1.178-2.512, p = 0.027). HEMS use was associated with better long-term functional outcome in patients with suspected LVO, independently of transportation time.

Cerebral arterial stiffness for predicting functional outcome in acute ischemic stroke.

To assess the association between cerebral arterial stiffness measured using the carotid-cerebral pulse wave velocity (ccPWV) and the functional outcome after acute ischemic stroke (AIS). We prospectively studied 336 consecutive patients (mean age, 60.58 ± 9.89 years; 73.81% male) with first-ever AIS who underwent examination by multimodal brain magnetic resonance, ccPWV, echocardiography, and carotid ultrasonography during the admission period. Ischemic stroke subtypes were classified using the Trial of Org 10172 in Acute Stroke Treatment classification system. A poor functional outcome was defined as a modified Rankin Scale score >2 at 3 months after stroke onset. We observed that 110 (32.74%) patients had a poor functional outcome. Multivariate logistic regression analysis revealed that ccPWV ≥ 6.66 m/s, calculated from the receiver operating characteristic (ROC) curve, was an independent predictor of a poor functional outcome [adjusted odds ratio, 6.27; 95% confidence interval (CI), 2.07-18.99]. ROC curve analysis showed that the area under the curve of ccPWV for predicting the 3-month functional outcome after AIS was 85.27% (95% CI, 80.95-89.58; P < 0.001). The optimal ccPWV cutoff point was 6.66 m/s, with a sensitivity of 82.73% and specificity of 77.88%. Furthermore, the addition of ccPWV to the predictive model significantly improved the discrimination ability for a poor functional outcome. Cerebral arterial stiffness, measured using the ccPWV on admission, has value as an independent prognostic factor for predicting the long-term functional outcome in patients with AIS.

Long-Term Outcomes for Arthroscopic Thermal Treatment for Scapholunate Ligament Injuries.

Background Arthroscopic electrothermal treatment of low-grade Geissler's scapholunate interosseous ligament (SLIL) tears has shown clinical benefit at short-term follow-up. Questions/Purpose This study aims to evaluate the long-term functional outcomes in patients undergoing this treatment. Patients and Methods A retrospective review of all patients treated between 2005 and 2013 was performed. Patients were excluded with less than 5 years of follow-up, the presence of static SLIL injuries, prior wrist surgery, and concomitant denervation. Symptom resolution, return to activity, postoperative complications, range of motion, grip strength, and subsequent treatment were recorded. Each patient completed Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Modified Mayo Wrist (MMW), and Patient-Rated Wrist Evaluation (PRWE) questionnaires. Results Nine patients underwent treatment for Geissler's grade I, II, and III SLIL injuries with a mean 7 years (range: 5-11 years) of follow-up. Mean grip strength was 99% of the nonsurgical extremity. Wrist motion was near symmetric with a mean of 76 (±14), 74 (±8), 21 (±13), and 40 degrees (±13) for wrist flexion, extension, radial deviation, and ulnar deviation. QuickDASH improved significantly by a mean 39 points (50 (preoperative)-11 [postoperative], p = 0.009). Postoperative MMW and PRWE scores were 83 and 14, respectively. Visual analog scale (VAS) score was 1.4. A total of 90% was returned to their preinjury level of function or higher. Conclusions Arthroscopic electrothermal treatment of low-grade Geissler's SLIL tears demonstrates excellent objective and subjective outcomes at a minimum 5-year follow-up, providing evidence that this is an effective, safe, and, most importantly, durable-therapeutic modality. Level of Evidence This is a Level IV, case series study.

Systemic inflammatory response syndrome and long-term outcome after intracerebral hemorrhage.

ObjectiveTo investigate whether the systemic inflammatory response syndrome (SIRS) without infection as surrogate of a systemic immune response is associated with poor long-term functional outcome in patients with spontaneous intracerebral hemorrhage (ICH).MethodsWe analyzed consecutive patients with spontaneous ICH from our prospective cohort study (2018–2015). SIRS was defined according to standard criteria: i.e., 2 or more of the following parameters during hospitalization: body temperature <36°C or >38°C, respiratory rate >20 per minute, heart rate >90 per minute, or white blood cell count <4,000/μL or >12,000/μL in the absence of infection. The primary outcome consisted of the modified Rankin Scale (mRS) at 3 and 12 months investigated by adjusted ordinal shift analyses. Bias and confounding were addressed by propensity score matching and multivariable regression models.ResultsOf 780 patients with ICH, 21.8% (n = 170) developed SIRS during hospitalization. Patients with SIRS showed more severe ICH compared with those without; i.e., larger ICH volumes (18.3 cm3, interquartile range [IQR 4.6–47.2 cm3] vs 7.4 cm3, IQR [2.4–18.6 cm3]; p < 0.01), increased intraventricular hemorrhage (57.6%, n = 98/170 vs 24.8%, n = 79/319; p < 0.01), and poorer neurologic admission status (NIH Stroke Scale score 16, IQR [7–30] vs 6, IQR [3–12]; p < 0.01). ICH severity-adjusted analyses revealed an independent association of SIRS with poorer functional outcome after 3 (OR 1.80, 95% CI [1.08–3.00]; p = 0.025) and 12 months (OR 1.76, 95% CI [1.04–2.96]; p = 0.034). Increased ICH volumes on follow-up imaging (OR 1.38, 95% CI [1.01–1.89]; p = 0.05) and previous liver dysfunction (OR 3.01, 95% CI [1.03–10.19]; p = 0.04) were associated with SIRS.ConclusionsIn patients with ICH, we identified SIRS to be predictive of poorer long-term functional outcome over the entire range of mRS estimates. Clinically relevant associations with SIRS were documented for previous liver dysfunction and hematoma enlargement.

Long-Term Functional Outcome for Patients Treated under Drip and Stay versus Drip and Ship Paradigm: A Single Network Experience.

Long-Term Functional Outcome for Patients Treated under Drip and Stay versus Drip and Ship Paradigm: A Single Network Experience.

Functional outcome 3–6 years after operative treatment of closed Weber B ankle fractures with or without syndesmotic fixation

BackgroundTo compare the long-term functional outcomes of patients surgically treated for Weber B ankle fractures with or without syndesmotic fixation. MethodsIn total, 959 adult patients with previous treatment with open reduction and internal fixation (ORIF) for closed ankle fractures were eligible for inclusion in a cross-sectional postal survey 3–6 years after surgery; 645 had Weber B fractures. The survey assessed functional outcomes with three validated ankle questionnaires. ResultsIn total 365 (57%) patients responded at a median of 4.2 years after the trauma. After adjusting for age, sex, education, smoking status, body mass index, diabetes, physical status before surgery, fracture classification, and duration of surgery, patients with a syndesmotic fixation had no different OMAS score (p = 0.98), LEFS score (p = 0.61), and SEFAS score (p = 0.98) than those without a syndesmotic fixation. Trimalleolar fracture was associated with worse functional outcomes than unimalleolar on two of the scales, the OMAS (p = 0.028) and LEFS (p = 0.046). ConclusionsIn multivariable analysis, patients with a syndesmotic fixation had no worse long-term functional outcomes than those without syndesmotic fixation.

Long term self-reported post-operative outcomes of endoscopic and open pharyngeal pouch repairs

Background: In recent years, there has been a shift to treating pharyngeal pouches endoscopically, however few studies report the long-term functional outcomes of patients following these repairs. Our aim is to investigate and compare the self-reported long-term functional outcomes of endoscopic and open pharyngeal pouch repair. Methods: A retrospective cohort analysis was performed using patient records to identify patients who had undergone either an open or endoscopic pharyngeal pouch repair from 2002-2018. Patients were then contacted and interviewed regarding their current swallowing status according to the M.D. Anderson Dysphagia Inventory (MDADI). Results: Of 185 identified, a total of 73 (37 female, mean age 77.4±10 years) participants were interviewed. Sixteen patients had undergone an open repair, and 57 endoscopic repair. Mean time interval between surgery and completion of interview was four years and three months (range, 3 months – 14 years 6 months). Overall mean global score for MDADI was 76.2±15 across all participants, 76.1±14.4 for endoscopic repair participants, and 76.4±17.9 for open repair participants. A Mann-Whitney U test comparing global MDADI of both procedure types was non-significant U =445, P=0.883, two-tailed. Conclusions: These findings suggest that decisions as to which surgical technique to select for pharyngeal pouch repair may be made according to surgical preference or other considerations other than concern over long-term patient swallowing outcomes. Our results indicate there is no statistically significant difference between endoscopic versus open pharyngeal pouch repair with regards to long-term patient-reported swallowing function.

Impact of antiepileptic drugs for seizure prophylaxis on short and long-term functional outcomes in patients with acute intracerebral hemorrhage: A meta-analysis and systematic review

PurposeThe purpose of this analysis is to assess the effect of antiepileptics (AEDs) on seizure prevention and short and long term functional outcomes in patients with acute intracerebral hemorrhage. MethodThe meta-analysis was conducted using the PRISMA guidelines. A literature search was performed of the PubMed, the Cochrane Library, and EMBASE databases. Search terms included “Anticonvulsants”, “Intracerebral Hemorrhage”, and related subject headings. Articles were screened and included if they were full-text and in English. Articles that did not perform multivariate regression were not included. Overall effect size was evaluated with forest plots and publication bias was assessed with the Begg’s and Egger’s tests. ResultsA total of 3912 articles were identified during the initial review. After screening, 54 articles remained for full review and 6 articles were included in the final analysis. No significant association between the use of AEDs after ICH and functional outcome (OR 1.53 [95%CI: 0.81–2.88] P = 0.18, I2 = 81.7%). Only one study evaluated the effect AEDs had in preventing post-ICH seizures. ConclusionsThe use of prophylactic AEDs was not associated with improved short and long outcomes after acute ICH. This analysis supports the 2015 AHA/ASA recommendation against prophylactic AEDs (class III; level of evidence b).

Clinical complications and outcomes of angiographically negative subarachnoid hemorrhage.

To define the in-hospital course, complications, short- and long-term functional outcomes of patients with angiographically negative subarachnoid hemorrhage (anSAH), particularly those with aneurysmal-pattern anSAH (aanSAH). Retrospective cohort study of patients with aneurysmal subarachnoid hemorrhage (aSAH), aanSAH, and perimesencephalic-pattern anSAH (panSAH) treated at a single tertiary referral center between January 2006 and April 2018. Ninety-nine patients with anSAH (33 aanSAH and 66 panSAH) and 464 patients with aSAH were included in this study. Outcomes included symptomatic hydrocephalus requiring CSF drainage, need for ventriculoperitoneal shunt, radiographic vasospasm, delayed cerebral ischemia (DCI), radiographic infarction, disability level within 1 year of ictus, and at last clinical follow-up as defined by the modified Rankin Scale. Patients with aanSAH and panSAH had similar rates of DCI and radiologic infarction, and patients with aanSAH had significantly lower rates compared to aSAH (p ≤ 0.018). Patients with aanSAH were more likely than those with panSAH to require temporary CSF diversion and ventriculoperitoneal shunt (p ≤ 0.03), with similar rates to those seen in aSAH. Only one patient with anSAH died in the hospital. Compared to those with aSAH, patients with aanSAH were significantly less likely to have a poor functional outcome within 1 year of ictus (odds ratio 0.26, 95% confidence interval 0.090-0.75) and at last follow-up (hazard ratio 0.30, 95% confidence interval 0.19-0.49, p = 0.002). DCI is very uncommon in anSAH, but patients with aanSAH have a similar need for short- and long-term CSF diversion to patients with aSAH. Nevertheless, patients with aanSAH have significantly better short- and long-term outcomes.

0956 Prevalence Of Nocturnal Tachyarrhythmias and Long-term Functional Outcome in Patients With Obstructive Sleep Apena Syndrome and Acute Ischemic Stroke

0956 Prevalence Of Nocturnal Tachyarrhythmias and Long-term Functional Outcome in Patients With Obstructive Sleep Apena Syndrome and Acute Ischemic Stroke

Long-term functional outcomes after surgical treatment of nonspecific thoracic outlet syndrome: Retrospective study of 70 cases at a mean of 8 years’ follow-up

Our objective was to study the clinical and functional outcomes after surgical treatment of nonspecific thoracic outlet syndrome (TOS) using a supraclavicular approach. We included every patient with TOS who was treated surgically by the same surgeon at a single hospital between 1999 and 2014 with a minimum follow-up of 4 years. The primary outcome was the overall evaluation of the function by the QuickDASH Score. Secondary outcomes included functional, subjective outcomes, pain levels, and neuropathic features. The clinical outcome of 70 cases was evaluated with a mean follow-up of 8.5 years. The improvement in the QuickDASH Score was significant with an average change of 38 points. Mean pain intensity was reduced postoperatively by 1.6 points from 5.1/10 to 3.5/10. Persistent pain rate at 4/10 or more remained in 56% of cases. These cases were mostly neuropathic. The surgical procedure significantly reduced the number of patients suffering from paresthesia, numbing or weakness. The possibility of sequelae and the persistence of neuropathic pain means the surgical indication should be limited to patients with significant functional disability despite well-conducted rehabilitation. The long-term functional outcomes in patients undergoing TOS was mostly good but could be improved by addressing residual neuropathic pain symptoms.