Long-Term Outcome in Surviving Patients After Clipping of Intracranial Aneurysms

Autor: Kanchan Kumar Mukherji, Sunil Gupta, Virender K. Khosla, Manoj K Tewari, Arpita Sharma, Rajesh Chhabra, Suresh Narain Mathuriya, Ashis Pathak, Alok Umredkar, Praveen Salunke, Sandeep Mohindra, Navneet Singla
Rok vydání: 2014
Předmět:
Zdroj: World Neurosurgery. 81:316-321
ISSN: 1878-8750
DOI: 10.1016/j.wneu.2013.01.034
Popis: Objective The quality of life and functional outcome may be significantly impaired in patients of aneurysmal subarachnoid hemorrhage. The purpose of the present study was to assess the status of patients undergoing surgical clipping of intracranial aneurysms in a long-term follow-up and to identify factors affecting outcome. Methods 494 patients who underwent clipping of their intracranial aneurysms with a minimum follow-up of 1 year after their discharge were studied. Preoperative factors such as age, Hunt and Hess grade, Fisher grade, time interval between ictus and surgery, and site of aneurysm were recorded. The long-term status was assessed using Glasgow Outcome Scale (GOS), Modified Rankin Scale (MRS), Barthel index (BI), and Mini-Mental State Examination (MMSE). Results Site of aneurysm and ictus–surgery interval did not have any effect on any parameter at long-term follow-up. Majority of patients who were discharged continued to improve as measured by GOS, Modified Rankin Scale, and Barthel index. However a significant proportion of patients had impaired MMSE at long-term follow-up. Multivariate analysis showed a significant effect of age on MMSE and also a positive correlation between number of aneurysms and GOS. Conclusions Most patients who survived and were discharged continued to improve in the postoperative period even though the immediate postoperative outcome was not favorable in many. However, a substantial subset had impaired cognitive function.
Databáze: OpenAIRE
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