Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

Abstract Introduction Even in this modern era of neurosurgery, we could not achieve 0% mortality in operated aneurysmal subarachnoid hemorrhage (SAH) patients. An analysis of factors affecting outcome was never published in detail, and a recent update of guidelines for management of ane...

Full description

Saved in:
Bibliographic Details
Main Authors: Mayank Bansal, R. S. Mittal
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2015-07-01
Series:Indian Journal of Neurosurgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1558966
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849414994989416448
author Mayank Bansal
R. S. Mittal
author_facet Mayank Bansal
R. S. Mittal
author_sort Mayank Bansal
collection DOAJ
description Abstract Introduction Even in this modern era of neurosurgery, we could not achieve 0% mortality in operated aneurysmal subarachnoid hemorrhage (SAH) patients. An analysis of factors affecting outcome was never published in detail, and a recent update of guidelines for management of aneurysm SAH noted deficiency in knowledge about this issue. Objective The study aims to assess the effect of various factors on the outcome of operated aneurysmal SAH patients. Methods: The various factors regarding age, sex, associated chronic diseases, clinical condition of patients, surgery interval, and nature of aneurysm were correlated with outcomes of 345 operated aneurismal SAH patients. Statistical analysis was done by chi-square test and logistic regression. Results As per grade, patients' survival is 80.16% for fair grade and 21.65 % for poor grade, which was statistically significant (p < 0.001). No significant difference was observed for other factors analyzed independently (p > 0.05). On comparing with Hunt and Hess (H-H) grade, all the above-mentioned variables showed significantly better survival in fair grade than in poor grade (p < 0.05). The Wald criteria demonstrated that only H-H grade made a significant contribution to prediction. Conclusion Although a number of factors seem to affect the outcome of aneurismal SAH patients, it is the grade at presentation, which comes out to be an independent variable, influencing the outcome of patients. Patients presented with fair grade tend to have better outcome than those presented with poor grade. All other factors do not have significant impact over the outcome of clipped aneurysm patients with SAH.
format Article
id doaj-art-6a52fb9e86514a0eba64c4ffb501fe78
institution Kabale University
issn 2277-954X
2277-9167
language English
publishDate 2015-07-01
publisher Thieme Medical and Scientific Publishers Pvt. Ltd.
record_format Article
series Indian Journal of Neurosurgery
spelling doaj-art-6a52fb9e86514a0eba64c4ffb501fe782025-08-20T03:33:39ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672015-07-01040206306810.1055/s-0035-1558966Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid HemorrhageMayank Bansal0R. S. Mittal1Department of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, IndiaDepartment of Neurosurgery, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, IndiaAbstract Introduction Even in this modern era of neurosurgery, we could not achieve 0% mortality in operated aneurysmal subarachnoid hemorrhage (SAH) patients. An analysis of factors affecting outcome was never published in detail, and a recent update of guidelines for management of aneurysm SAH noted deficiency in knowledge about this issue. Objective The study aims to assess the effect of various factors on the outcome of operated aneurysmal SAH patients. Methods: The various factors regarding age, sex, associated chronic diseases, clinical condition of patients, surgery interval, and nature of aneurysm were correlated with outcomes of 345 operated aneurismal SAH patients. Statistical analysis was done by chi-square test and logistic regression. Results As per grade, patients' survival is 80.16% for fair grade and 21.65 % for poor grade, which was statistically significant (p < 0.001). No significant difference was observed for other factors analyzed independently (p > 0.05). On comparing with Hunt and Hess (H-H) grade, all the above-mentioned variables showed significantly better survival in fair grade than in poor grade (p < 0.05). The Wald criteria demonstrated that only H-H grade made a significant contribution to prediction. Conclusion Although a number of factors seem to affect the outcome of aneurismal SAH patients, it is the grade at presentation, which comes out to be an independent variable, influencing the outcome of patients. Patients presented with fair grade tend to have better outcome than those presented with poor grade. All other factors do not have significant impact over the outcome of clipped aneurysm patients with SAH.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1558966aneurysmsubarachnoid hemorrhageclippinghunt and hess grade
spellingShingle Mayank Bansal
R. S. Mittal
Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
Indian Journal of Neurosurgery
aneurysm
subarachnoid hemorrhage
clipping
hunt and hess grade
title Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
title_full Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
title_fullStr Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
title_full_unstemmed Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
title_short Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage
title_sort clinical demographic association and outcome in patients with aneurysmal subarachnoid hemorrhage
topic aneurysm
subarachnoid hemorrhage
clipping
hunt and hess grade
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1558966
work_keys_str_mv AT mayankbansal clinicaldemographicassociationandoutcomeinpatientswithaneurysmalsubarachnoidhemorrhage
AT rsmittal clinicaldemographicassociationandoutcomeinpatientswithaneurysmalsubarachnoidhemorrhage