Long-term survival outcomes and prognostic factors related to ruptured intracranial aneurysms: A comparison of surgical and endovascular options in a propensity score-matched, nationwide population-based cohort study

被引:8
作者
Lo, Yang-Lan [1 ]
Li, Ming-Chang [2 ]
Yu, Ying-Hui [2 ]
Chen, Ho-Min [3 ,4 ]
Wu, Szu-Yuan [3 ,4 ,5 ,6 ,7 ,8 ,9 ]
机构
[1] Lotung Poh Ai Hosp, Los Hsu Med Fdn, Dept Neurosurg, Yilan, Taiwan
[2] Lotung Poh Ai Hosp, Los Hsu Med Fdn, Dept Colorectal Surg, Yilan, Taiwan
[3] Asia Univ, Coll Med & Hlth Sci, Dept Food Nutr & Hlth Biotechnol, Taichung, Taiwan
[4] Lotung Poh Ai Hosp, Los Hsu Med Fdn, Big Data Ctr, Yilan, Taiwan
[5] Lotung Poh Ai Hosp, Los Hsu Med Fdn, Div Radiat Oncol, Yilan, Taiwan
[6] Asia Univ, Coll Med & Hlth Sci, Dept Healthcare Adm, Taichung, Taiwan
[7] Fu Jen Catholic Univ, Grad Inst Business Adm, Taipei, Taiwan
[8] Taipei Med Univ, Wan Fang Hosp, Ctr Reg Anesthesia, Taipei, Taiwan
[9] Taipei Med Univ, Wan Fang Hosp, Ctr Pain Med, Taipei, Taiwan
关键词
endovascular coil embolization; prognostic factors; ruptured intracranial aneurysm; surgical clipping; survival; CONCURRENT CHEMORADIOTHERAPY; SUBARACHNOID HEMORRHAGE; DETACHABLE COILS; THERAPY; HEALTH; TRIAL; ISAT;
D O I
10.1111/ene.15002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purpose To determine the long-term survival outcomes of and prognostic factors for survival in patients with a ruptured intracranial aneurysm (RIA) who underwent endovascular coil embolization or surgical clipping. Methods We selected patients who had received a diagnosis of RIA between January 1, 2011 and December 31, 2017. Propensity score matching was performed, and Cox proportional hazards model curves were plotted to analyze all-cause mortality in patients undergoing different treatments. Results The matching process yielded a final cohort of 8102 patients (4051 and 4051 in endovascular coil embolization and surgical clipping groups, respectively) who were eligible for inclusion. In multivariate Cox regression analyses, the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for endovascular coil embolization compared with surgical clipping were 0.87 (95% CI, 0.79-0.97). The aHRs for the ages of 65 to 74, 75 to 84, and >= 85 years compared with the ages of 20 to 64 years were 1.82 (95% CI, 1.60-2.07), 3.35 (95% CI, 2.93-3.84), and 6.99 (95% CI, 5.51-8.86), respectively. Surgical clipping; old age; male sex; treatment during 2011 to 2013; presence of diabetes, congestive heart failure, hypertension, chronic kidney disease, or end-stage renal disease; history of stroke or transient ischemic attack; Charlson Comorbidity Index >= 2; attendance of nonacademic hospitals; and low income were significant independent prognostic factors for poor survival. Conclusions Compared with surgical clipping, endovascular coil embolization led to more favorable survival outcomes in patients with RIAs.
引用
收藏
页码:3012 / 3021
页数:10
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