gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Treatment results of patients with aneurysmal subarachnoid hemorrhage: outcome and prognostic factors in a large contemporary series

Meeting Abstract

  • E. Güresir - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • P. Schuss - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • J. Konczalla - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • J. Platz - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • H. Vatter - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann Wolfgang Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocFR.09.02

doi: 10.3205/12dgnc236, urn:nbn:de:0183-12dgnc2361

Published: June 4, 2012

© 2012 Güresir et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: To report the management and outcome of patients with aneurysmal subarachnoid hemorrhage (SAH) in a large contemporary series.

Methods: From 1999 to 2010, 1797 patients admitted with subarachnoid hemorrhage in our institution. Patient and aneurysm specific characteristics as well as treatment and SAH related complications were entered into our prospectively conducted database. Treatment decision was based on an interdisciplinary approach. Outcome was assessed according to modified Rankin scale (mRs) at 6 months (0–2 favourable vs. 3–6 unfavourable).

Results: Treatment was performed endovascular in 56% and surgical in 44% of the patients with aneurysmal SAH. 37% of the patients who underwent clipping versus 33% who underwent endovascular treatment were in poor grade (H&H 4–5) at admission. Treatment related complications included ischemic brain infarction, thrombembolic events, and bleeding, and was 8.8% for surgery, and 9.3% for endovascular treatment. Overall favourable outcome was achieved in 72.4% of patients treated surgically versus 76.3% treated endovascularly. In the multivariate analysis, poor grade at admission (p < 0.0001, OR 4.6, 95% CI 3.0–7.2), age > 65 years (p < 0.0001, OR 4.1, 95% CI 2.4–6.9), additional intracerebral hematoma (p = 0.001, OR 2.3, 95% CI 1.4–3.8), and hydrocephalus at admission (p < 0.0001, OR 2.9, 95% CI 1.8–4.9) were predictors for poor outcome after 6 months.

Conclusions: Despite of a high rate of poor grade patients at admission, a significant number of patients achieve favourable outcome in an interdisciplinary setting.