Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria.
Department of Neurosurgery, Medical University of Erlangen-Nuernberg, Erlangen, Germany.
Wien Klin Wochenschr. 2022 Feb;134(3-4):169-173. doi: 10.1007/s00508-021-01887-y. Epub 2021 Jun 15.
The incidence of aneurysms is steadily increasing in older patients due to the aging population. This study compared radiological parameters as well as clinical outcomes between patients younger than 65 years and those over 65 years of age, with special respect to individual treatment options.
Retrospective data were obtained for patients with cerebral aneurysms at a single academic institution within a 7-year period. Data reviewed included admission protocols, patient charts, operating reports as well as outpatient clinic charts. Aneurysmal characteristics as well as surgical outcome were compared between older patients, defined as patients older than 65 years of age, and a control group of patients younger than 65 years of age. To evaluate and compare individual clinical characteristics various scores including the Hunt and Hess score, the Fisher score, and the Glasgow outcome scale were used.
A total of 347 patients were included in the final analysis. The control group included 290 patients, while 57 patients were in the older patient group. Neither the Hunt and Hess scores nor Fisher scores were significantly correlated to patient age. The Glasgow outcome scale was significantly lower in the older group after clipping of ruptured aneurysms (p < 0.000) but not significantly different after clipping of unruptured aneurysms (p = 0.793).
Postoperative Glasgow outcome scale scores were not significantly different after clipping of unruptured cerebral aneurysms approximately 1 cm in diameter in older patients compared to the younger age group. Therefore, clipping of unruptured cerebral aneurysms may also be a valuable treatment option for older patients.
由于人口老龄化，老年患者的动脉瘤发病率稳步上升。本研究比较了年龄小于 65 岁和大于 65 岁的患者的影像学参数和临床结果，特别关注了个体治疗选择。
回顾性收集了一家学术机构 7 年内的脑动脉瘤患者数据。回顾的数据包括入院方案、患者病历、手术报告以及门诊病历。比较了老年患者（定义为年龄大于 65 岁）和年龄小于 65 岁的对照组患者的动脉瘤特征和手术结果。为了评估和比较个体临床特征，使用了各种评分，包括 Hunt 和 Hess 评分、Fisher 评分和 Glasgow 预后评分。
共有 347 例患者纳入最终分析。对照组包括 290 例患者，老年组包括 57 例患者。Hunt 和 Hess 评分和 Fisher 评分均与患者年龄无显著相关性。夹闭破裂动脉瘤后，老年组的 Glasgow 预后评分显著降低（p<0.000），但夹闭未破裂动脉瘤后差异无统计学意义（p=0.793）。
对于直径约 1cm 的未破裂脑动脉瘤，与年轻患者相比，老年患者夹闭未破裂脑动脉瘤后的术后 Glasgow 预后评分无显著差异。因此，夹闭未破裂脑动脉瘤也可能是老年患者的一种有价值的治疗选择。
