Incidence and Outcomes of Aneurysmal Subarachnoid Hemorrhage: A Multicenter Retrospective Registry-based Descriptive Trial in Kobe City

被引：1

作者：

Ohta, Tsuyoshi ^{[1
]}

Matsumoto, Shirabe ^{[1
]}

Fukumitsu, Ryu ^{[1
]}

Imamura, Hirotoshi ^{[1
]}

Adachi, Hidemitsu ^{[2
]}

Hara, Yoshie ^{[3
,4
]}

Hosoda, Kohkichi ^{[1
,5
]}

Kimura, Hidehito ^{[6
]}

Kuwayama, Kazuyuki ^{[7
]}

Mizowaki, Takashi ^{[8
]}

Motooka, Yasuhiko ^{[9
]}

Miyata, Shiro ^{[10
]}

Shinoda, Narihide ^{[11
]}

Ueno, Yasushi ^{[12
]}

Yamaura, Ikuya ^{[13
]}

Yoshida, Yasuhisa ^{[13
]}

Sakai, Chiaki ^{[14
]}

Sakai, Nobuyuki ^{[14
]}

机构：

[1] Kobe City Med Ctr Gen Hosp, Dept Neurosurg, 2-1-1 Minatojima Minamimachi,Chuo Ku, Kobe, Hyogo 6500047, Japan

[2] Kobe City Med Ctr West Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

[3] Hyogo Emergency Med Ctr, Dept Neurosurg, Kobe, Hyogo, Japan

[4] Kobe Red Cross Hosp, Kobe, Hyogo, Japan

[5] Kobe City Nishi Kobe Med Ctr, Dept Neurosurg, Kobe, Hyogo, Japan

[6] Kobe Univ, Grad Sch Med, Dept Neurosurg, Kobe, Hyogo, Japan

[7] Japan Community Hlth Care Org, Dept Neurosurg, Kobe Cent Hosp, Kobe, Hyogo, Japan

[8] Shinsuma Gen Hosp, Dept Otolaryngol, Kobe, Hyogo, Japan

[9] Konan Med Ctr, Dept Neurosurg, Kobe, Hyogo, Japan

[10] Kobe Ekisaikai Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

[11] Kosei Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

[12] Shinko Mem Hosp, Dept Neurosurg, Kobe, Hyogo, Japan

[13] Yoshida Hosp, Cerebrovasc Res Inst, Dept Neurosurg, Kobe, Hyogo, Japan

[14] Kobe City Med Ctr Gen Hosp, Dept Nephrol, Kobe, Hyogo, Japan

来源：

NEUROLOGIA MEDICO-CHIRURGICA | 2023年 / 63卷 / 11期

关键词：

subarachnoid hemorrhage; intracranial aneurysm; prognosis; hydrocephalus; intracranial vasospasm; HYDROCEPHALUS; PREDICTORS; VASOSPASM; MORTALITY;

D O I：

10.2176/jns-nmc.2023-0090

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The current study aims to evaluate the incidence and results of aneurysmal subarachnoid hemorrhage (aSAH) throughout Kobe City. Based on a multicenter retrospective registry-based descriptive trial involving all 13 primary stroke centers in Kobe City, patients with aSAH treated between October 2017 and September 2019 were studied. A total of 334 patients were included, with an estimated age adjusted incidence of 11.12 per 100,000 person-years. Curative treatment was given to 94% of patients, with endovascular treatment (51%) preferred over surgical treatment (43%). Of the patients, 12% were treated by shunt surgery for sequential hydrocephalus with a worse outcome at 30 days or discharge (14% vs. 46%, odds ratio (OR): 0.19, 95% confidence interval (CI): 0.088-0.39, p-value <0.001). As for vasospasm and delayed cerebral ischemia, most patients were given intravenous fasudil infusion (73%), with endovascular treatment for vasospasm in 24 cases (7.2%). The fasudil group had more good outcomes (42% vs. 30%, OR: 1.64, 95% CI: 0.95-2.87, p-value = 0.075) and significantly less death (3.3% vs. 35%, OR: 0.064, 95% CI: 0.024-0.15, p-value <0.001) at 30 days or discharge. Mortality rose from 12% at 30 days or discharge to 17% at 1 year, but neurological function distribution improved over time (modified Rankin Scale 0-2 was 39% at 30 days or discharge, 53% at 60 days, and 63% at 1 year). Our retrospective registered trial presented various statistics on aSAH, summarizing the current treatment status and prognosis.

引用

页码：519 / 525

页数：7

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