Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis

Abstract The association between age and delayed cerebral ischemia (DCI) has long been controversial. This study aimed to explore the relationship between age and DCI in patients with aneurysmal subarachnoid hemorrhage (aSAH) requiring invasive mechanical ventilation (IMV). This study reanalyzed pre...

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Main Authors: Qing-qing Wu, Wei-wen Chen, Tian-lai Lin, Cun-rong Chen, Zhi-rong Ding, You-li Chen
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-88272-1
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author Qing-qing Wu
Wei-wen Chen
Tian-lai Lin
Cun-rong Chen
Zhi-rong Ding
You-li Chen
author_facet Qing-qing Wu
Wei-wen Chen
Tian-lai Lin
Cun-rong Chen
Zhi-rong Ding
You-li Chen
author_sort Qing-qing Wu
collection DOAJ
description Abstract The association between age and delayed cerebral ischemia (DCI) has long been controversial. This study aimed to explore the relationship between age and DCI in patients with aneurysmal subarachnoid hemorrhage (aSAH) requiring invasive mechanical ventilation (IMV). This study reanalyzed previously published data from a French university hospital. Chalard K et al. conducted a retrospective cohort study in the intensive care unit from 2010 to 2015. Univariate and multivariate logistic regression analyses were employed to identify risk factors for DCI. The non-linear relationship between age and DCI was estimated through a restricted cubic spline regression, and a two-piecewise linear regression model was further performed to calculate the threshold effect. The analysis included 222 patients with aSAH requiring IMV. Their median age was 56 years (range 19–84 years). Patients were equally divided into four groups: Q1 (19–45 years), Q2 (46–55 years), Q3 (56–63 years), and Q4 (64–84 years). The incidence of DCI was 27.48% (N = 61). After adjustment for potential confounders, patients in group Q2 were found to be more likely to develop DCI [odds ratio (OR), 4.91; 95% Confidence Interval (CI), 1.53–15.70] compared to those in group Q1. After adjusting for confounding variables, for patients aged < 53 years, the risk of DCI increased by 14% (OR, 1.14; 95% CI 1.05–1.23) for each 1-year increase in age. For patients aged 53 to 77 years, the risk of DCI decreased by 19% (OR, 0.81; 95% CI 0.73–0.88) for each 1-year increase. For patients aged > 77 years, the risk of DCI did not decrease with increasing age (OR, 1.42; 95% CI 0.47–4.34). Age was non-linearly associated with DCI in patients with aSAH requiring IMV.
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spelling doaj-art-080c42d1f2564db5943a63e9a06b0e002025-02-09T12:36:25ZengNature PortfolioScientific Reports2045-23222025-02-011511810.1038/s41598-025-88272-1Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysisQing-qing Wu0Wei-wen Chen1Tian-lai Lin2Cun-rong Chen3Zhi-rong Ding4You-li Chen5Department of Intensive Care Unit, Quanzhou First Hospital Affiliated Fujian Medical UniversityDepartment of Intensive Care Unit, Quanzhou First Hospital Affiliated Fujian Medical UniversityDepartment of Intensive Care Unit, Quanzhou First Hospital Affiliated Fujian Medical UniversityDepartment of Intensive Care Unit, Fujian Medical University Union HospitalDepartment of Intensive Care Unit, Quanzhou First Hospital Affiliated Fujian Medical UniversityDepartment of Intensive Care Unit, Quanzhou First Hospital Affiliated Fujian Medical UniversityAbstract The association between age and delayed cerebral ischemia (DCI) has long been controversial. This study aimed to explore the relationship between age and DCI in patients with aneurysmal subarachnoid hemorrhage (aSAH) requiring invasive mechanical ventilation (IMV). This study reanalyzed previously published data from a French university hospital. Chalard K et al. conducted a retrospective cohort study in the intensive care unit from 2010 to 2015. Univariate and multivariate logistic regression analyses were employed to identify risk factors for DCI. The non-linear relationship between age and DCI was estimated through a restricted cubic spline regression, and a two-piecewise linear regression model was further performed to calculate the threshold effect. The analysis included 222 patients with aSAH requiring IMV. Their median age was 56 years (range 19–84 years). Patients were equally divided into four groups: Q1 (19–45 years), Q2 (46–55 years), Q3 (56–63 years), and Q4 (64–84 years). The incidence of DCI was 27.48% (N = 61). After adjustment for potential confounders, patients in group Q2 were found to be more likely to develop DCI [odds ratio (OR), 4.91; 95% Confidence Interval (CI), 1.53–15.70] compared to those in group Q1. After adjusting for confounding variables, for patients aged < 53 years, the risk of DCI increased by 14% (OR, 1.14; 95% CI 1.05–1.23) for each 1-year increase in age. For patients aged 53 to 77 years, the risk of DCI decreased by 19% (OR, 0.81; 95% CI 0.73–0.88) for each 1-year increase. For patients aged > 77 years, the risk of DCI did not decrease with increasing age (OR, 1.42; 95% CI 0.47–4.34). Age was non-linearly associated with DCI in patients with aSAH requiring IMV.https://doi.org/10.1038/s41598-025-88272-1Aneurysmal subarachnoid hemorrhageMechanical ventilationAgeDelayed cerebral ischemia
spellingShingle Qing-qing Wu
Wei-wen Chen
Tian-lai Lin
Cun-rong Chen
Zhi-rong Ding
You-li Chen
Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
Scientific Reports
Aneurysmal subarachnoid hemorrhage
Mechanical ventilation
Age
Delayed cerebral ischemia
title Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
title_full Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
title_fullStr Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
title_full_unstemmed Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
title_short Relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation: a secondary analysis
title_sort relationship between age and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage requiring invasive mechanical ventilation a secondary analysis
topic Aneurysmal subarachnoid hemorrhage
Mechanical ventilation
Age
Delayed cerebral ischemia
url https://doi.org/10.1038/s41598-025-88272-1
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