{"id":"f658b5f3-9f7a-4666-b997-a38641c8fb90","slug":"age-limit-for-surgical-treatment-of-poor-grade-patients-with-subarachnoid-hemorrhage-a-project-of-the-chugoku-shikoku-division-of-the-japan-neurosurgical-society","title":"Age limit for surgical treatment of poor-grade patients with subarachnoid hemorrhage: A project of the Chugoku-Shikoku division of the Japan neurosurgical society","authors":["Satoshi Shirao","Hiroshi Yoneda","Ichiro Kunitsugu","Eiichi Suehiro","Hiroyasu Koizumi","Michiyasu Suzuki"],"abstract":"Objective: Management of elderly patients with poor-grade subarachnoid hemorrhage (SAH) remains controversial. The objective of this study was to investigate whether there is an age-dependent difference in the outcome of poor-grade SAH after surgical obliteration of the aneurysm. Methods: Data were reviewed retrospectively for 156 patients with poor-grade aneurysmal SAH at multiple centers in Chugoku and Shikoku, Japan. Patients were divided into age groups of 65-74 and ≥75 years old. Factors influencing a favorable outcome at discharge (Glasgow Outcome Scale, good recovery or moderately disabled) were determined using multivariate logistic regression analyses. Results: A favorable outcome at discharge was achieved in 37 of the 156 patients (23.7%). Advanced age (≥75 years old, P P = 0.02), Fisher grade (P P P = 0.01), Fisher group 4 (P = 0.002), and a new LDA associated with vasospasm on CT (P = 0.007) as predictors of a poor outcome in elderly patients with poor-grade SAH after surgical obliteration of the aneurysm. WFNS Grade V at admission (P = 0.052) was weakly associated with a poor outcome. Conclusions: Advanced age (≥75 years old), Fisher group 4, and LDA associated with vasospasm on CT were independent predictors of clinical outcome in elderly patients with poor-grade SAH. A favorable outcome in these patients occurred more frequently after Guglielmi detachable coil embolization than after surgical clipping, but without a significant difference.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/f658b5f3-9f7a-4666-b997-a38641c8fb90/featured/hero-1782420981908.png","publishDate":"2012-11-27T00:00:00.000Z","doi":"10.4103/2152-7806.103886","categories":["Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/f658b5f3-9f7a-4666-b997-a38641c8fb90/pdf"}