Horiuchi Tetsuyoshi, Tsutsumi Keiji, Ito Kiyoshi, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
J Clin Neurosci. 2014 Sep;21(9):1567-9. doi: 10.1016/j.jocn.2013.11.047. Epub 2014 Apr 13.
This study investigated the outcome of clipping surgery for ruptured aneurysms in patients older than 80 years of age. From 1988 to 2011 data were retrospectively reviewed, and 196 patients treated with clipping obliteration for aneurysmal subarachnoid hemorrhage were identified. Patients were divided into two age groups of 80-84 and ⩾ 85 years old. The Glasgow Outcome Scale score was assessed at discharge and classified as favorable (good recovery or moderate recovery) or unfavorable (severe disability, vegetative state, or dead). Radiological and clinical characteristics were compared between the two groups. A favorable outcome was achieved in 106 (54.1%) of the 196 patients. Preoperative grade and Fisher grade were significantly associated with unfavorable outcome, but age was not. Based on logistic regression analysis, poor preoperative grade and ruptured anterior cerebral artery aneurysm were the predictors of unfavorable outcome, but advanced age (⩾ 85 years old) was not. Advanced age itself did not affect the outcome of the elderly patients who underwent clipping surgery for aneurysmal subarachnoid hemorrhage.
本研究调查了80岁以上破裂动脉瘤患者的夹闭手术结果。回顾了1988年至2011年的资料，确定了196例行动脉瘤性蛛网膜下腔出血夹闭术的患者。患者分为80 - 84岁和≥85岁两个年龄组。出院时评估格拉斯哥预后量表评分，并分为良好（恢复良好或中度恢复）或不良（严重残疾、植物状态或死亡）。比较两组的影像学和临床特征。196例患者中有106例（54.1%）获得了良好的结果。术前分级和Fisher分级与不良结果显著相关，但年龄无关。基于逻辑回归分析，术前分级差和大脑前动脉动脉瘤破裂是不良结果的预测因素，但高龄（≥85岁）不是。高龄本身并不影响接受动脉瘤性蛛网膜下腔出血夹闭手术的老年患者的结果。
