Age-Associated Vasospasm in Aneurysmal Subarachnoid Hemorrhage
| Autor: | Amer Alshekhlee, Saleem I. Abdulrauf, Salvador Cruz-Flores, Justin Sweeny, Nirav Vora, Afshin Borhani Haghighi, Randall C. Edgell, Jason A. Felton, Bruce K. Bieneman, Sushant P. Kale, Jacob Kitchener |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Subarachnoid hemorrhage Substance-Related Disorders Logistic regression Disability Evaluation Aneurysm Older patients Predictive Value of Tests Risk Factors Odds Ratio medicine Humans Vasospasm Intracranial cardiovascular diseases Aged Retrospective Studies Chi-Square Distribution Missouri medicine.diagnostic_test business.industry Incidence Incidence (epidemiology) Smoking Rehabilitation Age Factors Vasospasm Retrospective cohort study Middle Aged Subarachnoid Hemorrhage Prognosis medicine.disease Patient Discharge Cerebral Angiography nervous system diseases body regions Logistic Models Anesthesia cardiovascular system Female Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology Cerebral angiography |
| Zdroj: | Journal of Stroke and Cerebrovascular Diseases. 22:22-27 |
| ISSN: | 1052-3057 |
| Popis: | The relationship between age and vasospasm caused by subarachnoid hemorrhage (SAH) is controversial. We evaluated this relationship in a contemporary sample from a single institution. In a retrospective study design, we included patients with SAH caused by ruptured intracranial aneurysms. All patients underwent an evaluation that included head imaging, cerebral angiography, and treatment for the underlying aneurysm. Vasospasm was classified as absent, any vasospasm, or symptomatic vasospasm. Age was classified into 2 categories with a cutoff of 50 years, and also was stratified by decade. All patients had received preventative and therapeutic measures for vasospasm. Logistic regression analysis was used to assess the association between age and the occurrence of vasospasm. A total of 108 patients were included in this analysis, 67 of whom were age ≥50 years. The older patients had a higher incidence of vascular risk factors, and the younger patients had a higher incidence of smoking and illicit substance abuse. The mean age of the patients with any vasospasm (n = 41) was 48.51 ± 11.23 years, compared with 59.67 ± 13.30 years in those without vasospasm (P.0001). Adjusted analysis found a greater risk of vasospasm in the younger patients compared with the older patients (odds ratio, 5.83; 95% confidence interval, 2.41-14.12 for any vasospasm; odds ratio, 2.66; 95% confidence interval, 1.008-7.052 for symptomatic vasospasm). This risk of vasospasm decreased with advanced age (P.0001). Our findings suggest that patients age50 years are at 5-fold greater risk of any vasospasm compared with older patients, and that age-adjusted prevention protocols may need to be considered. |
| Databáze: | OpenAIRE |
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