Kazumata Ken, Kamiyama Hiroyasu, Ishikawa Tatsuya
Department of Neurosurgery, Teine Keijinkai Hospital, Sapporo, Japan.
J Stroke Cerebrovasc Dis. 2006 Jan-Feb;15(1):14-7. doi: 10.1016/j.jstrokecerebrovasdis.2005.08.007.
Although the recovery from an aneurysmal subarachnoid hemorrhage (SAH) is hampered by advanced age, the impact of age on surgical outcome has not been evaluated quantitatively. We studied 168 patients with SAH treated between 2000 and 2002. Study variables included sex, age, location of aneurysm, preoperative Glasgow coma scale (GCS) score, and presence of intracerebral hematoma, vasospasm, or hydrocephalus. Univariate and multiple logistic regression analyses were applied to test the effect of age and preoperative GCS scores on the likelihood of a favorable outcome. Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] = 1.109; 95% confidence interval [CI] = 1.051-1.169) and decrements of preoperative GCS score (OR = 0.69; 95% CI = 0.586-0.812) were inversely associated with the likelihood of a favorable outcome. Based on the results, we generated a reference table that depicts the outcome based on the preoperative GCS score stratified by age. This simple reference table is useful in predicting surgical outcome in emergent situations. This study indicated that a 10-year advance in age is equivalent to a 2.3-point reduction in the GCS score.
尽管高龄会阻碍动脉瘤性蛛网膜下腔出血(SAH)的恢复,但年龄对手术结果的影响尚未进行定量评估。我们研究了2000年至2002年间接受治疗的168例SAH患者。研究变量包括性别、年龄、动脉瘤位置、术前格拉斯哥昏迷量表(GCS)评分以及是否存在脑内血肿、血管痉挛或脑积水。采用单因素和多因素逻辑回归分析来检验年龄和术前GCS评分对良好预后可能性的影响。多因素逻辑回归分析显示,高龄(比值比[OR]=1.109;95%置信区间[CI]=1.051-1.169)和术前GCS评分降低(OR=0.69;95%CI=0.586-0.812)与良好预后的可能性呈负相关。基于这些结果,我们生成了一个参考表,该表根据年龄分层的术前GCS评分描述了预后情况。这个简单的参考表有助于预测紧急情况下的手术结果。本研究表明,年龄每增加10岁相当于GCS评分降低2.3分。