Clipping of unruptured intracranial aneurysms in patients older than sixty: An age-based analysis.

Autor: Daou BJ; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States., Muhlestein WE; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States., Palmateer G; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States., Thompson BG; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States., Pandey AS; Department of Neurosurgery, University of Michigan, Ann Arbor, MI, United States. Electronic address: adityap@med.umich.edu.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2021 Aug; Vol. 207, pp. 106737. Date of Electronic Publication: 2021 Jun 08.
DOI: 10.1016/j.clineuro.2021.106737
Abstrakt: Objective: The diagnosis of unruptured intracranial aneurysms (UIAs) is being made more frequently in elderly patients. The goal of this study is to evaluate complications and clinical outcome in patients ≥ 60 years-old who underwent clipping of UIAs.
Methods: We performed a retrospective cohort study. Clinical outcome (modified Rankin scale score) was determined at the latest clinical follow-up. Complications and outcomes were compared between age groups (60-69, 70-80) and subgroups (60-64, 65-69, 70-74, and >75).
Results: The study population consisted of 255 patients (range 60-80 years-old) who underwent 262 clipping procedures for UIAs. Mean follow-up duration was 15.6 months (± 27.5). Major complications occurred in 20 patients (7.6%) and mortality in 3 patients (1.1%). Medical complications occurred in 26 patients (10%). Mean length of hospital-stay was 4.7 days (± 5.8). 89.6% were discharged to home. 87.8% had a favorable clinical outcome. The 70-80 age group had significantly more complications (P = 0.03) than the 60-69 group and a significantly longer hospital stay (6.02 vs. 4.3 days, P = 0.04). The older group was less likely to discharge to home and more likely to require rehabilitation (P = 0.002). Favorable clinical outcome did not significantly differ between the two groups (85.7% vs. 88.4%, P = 0.56). There was a trend for increasing complications from the younger to older subgroups (P = 0.008) and a reduction in the likelihood to discharge to home (P < 0.0001). The rate of ultimate favorable clinical outcome did not differ significantly between subgroups (P = 0.79).
Conclusion: Although complications, length of hospital-stay, and discharge to non-home destinations increase with older age, the majority of patients ≥ 60 may have favorable clinical outcomes.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
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