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Factors and outcomes associated with ultra-early surgery for poor-grade aneurysmal subarachnoid haemorrhage: a multicentre retrospective analysis.

Zhao B, Zhao Y, Tan X, Cao Y, Wu J, Zhong M, Wang S - BMJ Open (2015)

Bottom Line: Multivariate analysis of predictors of poor outcome, ultraearly surgery was not an independent predictor of poor outcome, while advanced age, postresuscitation WFNS V grade, intraventricular haemorrhage, brain herniation and non-middle cerebral artery (MCA) aneurysms were associated with poor outcome.Patients of younger age, WFNS grade IV, absence of intraventricular haemorrhage, absence of brain herniation and MCA aneurysms are more likely to have a good outcome.Ultra-early surgery could improve outcomes in carefully selected patients with poor-grade aSAH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease), Beijing, China Department of Neurosurgery, First affiliated Hospital of Wenzhou Medical University, Wenzhou, China Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.

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Graph showing the receiver operating characteristic (ROC) curve of predictive value of poor outcome.
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BMJOPEN2014007410F1: Graph showing the receiver operating characteristic (ROC) curve of predictive value of poor outcome.

Mentions: Univariate logistic analysis showed that postresuscitation WFNS grade, Fisher grade, brain herniation, IVH, ultra-early surgery and pneumonia were associated with poor outcome (table 6). Multivariate logistic analysis showed that advanced age (p=0.010), postresuscitation WFNS grade V (p=0.012), brain herniation (p=0.038), IVH (p=0.017) and non-middle cerebral artery (MCA) aneurysms (p=0.028) were independent predictors of poor outcome (table 7). The multivariate model predicted poor outcome with an AUC of 0.80 (95% CI 0.72 to 0.88, p<0.001; figure 1). The timing of surgery was not an independent predictor of poor outcome.


Factors and outcomes associated with ultra-early surgery for poor-grade aneurysmal subarachnoid haemorrhage: a multicentre retrospective analysis.

Zhao B, Zhao Y, Tan X, Cao Y, Wu J, Zhong M, Wang S - BMJ Open (2015)

Graph showing the receiver operating characteristic (ROC) curve of predictive value of poor outcome.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401840&req=5

BMJOPEN2014007410F1: Graph showing the receiver operating characteristic (ROC) curve of predictive value of poor outcome.
Mentions: Univariate logistic analysis showed that postresuscitation WFNS grade, Fisher grade, brain herniation, IVH, ultra-early surgery and pneumonia were associated with poor outcome (table 6). Multivariate logistic analysis showed that advanced age (p=0.010), postresuscitation WFNS grade V (p=0.012), brain herniation (p=0.038), IVH (p=0.017) and non-middle cerebral artery (MCA) aneurysms (p=0.028) were independent predictors of poor outcome (table 7). The multivariate model predicted poor outcome with an AUC of 0.80 (95% CI 0.72 to 0.88, p<0.001; figure 1). The timing of surgery was not an independent predictor of poor outcome.

Bottom Line: Multivariate analysis of predictors of poor outcome, ultraearly surgery was not an independent predictor of poor outcome, while advanced age, postresuscitation WFNS V grade, intraventricular haemorrhage, brain herniation and non-middle cerebral artery (MCA) aneurysms were associated with poor outcome.Patients of younger age, WFNS grade IV, absence of intraventricular haemorrhage, absence of brain herniation and MCA aneurysms are more likely to have a good outcome.Ultra-early surgery could improve outcomes in carefully selected patients with poor-grade aSAH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University; China National Clinical Research Center for Neurological Diseases (Center of Stroke, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease), Beijing, China Department of Neurosurgery, First affiliated Hospital of Wenzhou Medical University, Wenzhou, China Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.

Show MeSH
Related in: MedlinePlus