Timing of operation for poor-grade aneurysmal subarachnoid hemorrhage: Relationship with delayed cerebral ischemia and poor prognosis

被引：9

作者：

Lu, Junlin ^{[1
]}

Wang, Liang ^{[2
]}

Li, Runting ^{[3
]}

Lin, Fa ^{[3
]}

Chen, Yu ^{[3
]}

Yan, Debin ^{[3
]}

Yang, Jun ^{[3
]}

Li, Ruinan ^{[3
]}

Li, Zhipeng ^{[3
]}

Zhang, Haibin ^{[3
]}

Han, Heze ^{[3
]}

Yuan, Kexin ^{[3
]}

Wang, Ke ^{[3
]}

Ren, Yihang ^{[3
]}

Chen, Xiaolin ^{[3
,4
,5
,6
,8
]}

Zhao, Yuanli ^{[3
,4
,5
,6
,7
]}

Zhao, Jizong ^{[3
,4
,5
,6
,7
,8
]}

机构：

[1] Sichuan Univ, West China Hosp, Dept Neurosurg, Chengdu, Peoples R China

[2] Tianjin Fifth Cent Hosp, Dept Neurosurg, Tianjin, Peoples R China

[3] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China

[4] China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China

[5] Beijing Inst Brain Disorders, Stroke Ctr, Beijing, Peoples R China

[6] Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China

[7] Beijing Translat Engn Enter 3D Printer Clin Neuros, Beijing, Peoples R China

[8] Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing 100070, Peoples R China

来源：

CNS NEUROSCIENCE & THERAPEUTICS | 2023年 / 29卷 / 04期

基金：

中国国家自然科学基金;

关键词：

delayed cerebral ischemia; prognosis; subarachnoid hemorrhage; timing of surgery; RUPTURED INTRACRANIAL ANEURYSMS; ENDOVASCULAR COILING; SURGERY; TRIAL; ISAT;

D O I：

10.1111/cns.14088

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

AimsTo assess differences in the clinical prognosis between different treatment timings in poor-grade (Hunt and Hess grade 4-5) aneurysmal subarachnoid hemorrhage patients. MethodsThe treated 127 poor-grade aneurysmal subarachnoid hemorrhage patients were divided into three groups: early treatment within 2 days, treatment on days 3 to 10, and treatment for more than 10 days after the hemorrhage. Odd ratios with a 95% confidence interval were calculated in logistic regression for different timing strategies regarding delayed cerebral ischemia and poor prognosis at 3 months. Subgroup analyses were conducted to determine whether the different timing strategies affect the prognosis. ResultsPatients who received the treatment on days 3 to 10 were prone to develop delayed cerebral ischemia and poor prognosis at 3 months. Postponing treatment in patients older than 55 years or diagnosed with an intraventricular hematoma on the initial computed tomography scan may lead to poor prognosis, with the early intervention group as a reference. ConclusionsEarly intervention in poor-grade aneurysmal subarachnoid hemorrhage is suggested to be implemented. The treatment on 3 to 10 days harbored the highest risk of poor prognosis; patients might benefit more from early intervention, especially for ones older than 55 years or diagnosed with an intraventricular hematoma.

引用

页码：1120 / 1128

页数：9

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