ArticleActa neurochirurgica2024
Risk factors for poor outcome after aneurysmal subarachnoid hemorrhage in patients with initial favorable neurological status.
Article in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Outcomes following intraoperative rupture of cerebral aneurysms during microsurgical clipping: a systematic review and meta-analysis.Neurosurgical review · 2026Pooled it
- Causes of Unfavorable Outcome in Patients With Aneurysmal Subarachnoid Hemorrhage in Clinical Grade World Federation of Neurosurgical Societies I-III Before Aneurysm Treatment: Impact of Adverse Events.Neurosurgery practice · 2026Article
- Cost-utility framework to evaluate therapeutic interventions targeting reduction in cerebral infarction among aneurysmal subarachnoid hemorrhage patients.Neurosurgical review · 2026Article
- Branch-Critical Clipping of a Ruptured Carotid-Posterior Communicating Aneurysm with Fetal PCA Configuration.Diagnostics (Basel, Switzerland) · 2026Article
- Inflammation, coagulation, and nutritional reserves refine 90-day prognostic stratification after ruptured intracranial aneurysm repair.Frontiers in nutrition · 2026Article
- Early peripheral blood gene expression predicts 90-day outcomes following subarachnoid hemorrhage.Journal of neuroinflammation · 2025Article
- Predicting Shunt-Dependency After Aneurysmal Subarachnoid Hemorrhage: A Multicenter Validation Study.Journal of clinical medicine · 2025Article
- Geographical accessibility and case loads in subarachnoid hemorrhage care: a nationwide study of German hospitals.Neurosurgical review · 2025Observational
- Multi-class subarachnoid hemorrhage severity prediction: addressing challenges in predicting rare outcomes.Neurosurgical review · 2025Article
- Pentraxin 3 as a Prognostic Biomarker in Aneurysmal Subarachnoid Hemorrhage.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Spinal Drainage and Combined Pharmacotherapy as Potential Strategies to Improve Outcomes for Patients with Poor-Grade Subarachnoid Hemorrhage Treated with Clipping or Coiling but Not Receiving Nimodipine.Journal of clinical medicine · 2025Article
- Identifying Patients at Increased Risk for Poor Outcomes Among Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients: The IPOGRO Risk Model.Journal of personalized medicine · 2024Article
- Addressing Challenges in Cerebral Aneurysm Management: Strategies to Enhance Patient Outcomes.Journal of clinical medicine · 2024Article
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAneurysmal subarachnoid hemorrhage (aSAH) remains a devastating diagnosis. A poor outcome is known to be highly dependent on the initial neurological status. Our goal was to identify other parameters that favor the risk of complications and poor outcome in patients with aSAH and initially favorable neurologic status.
methodsConsecutive aSAH cases treated at our hospital between 01/2003 and 06/2016 with the initial World Federation of Neurosurgical Societies grades I-III were included. Data on demographic characteristics, previous medical history, initial aSAH severity, and functional outcome after aSAH were collected. The study endpoints were the occurrence of cerebral infarcts, in-hospital mortality, and unfavorable outcome at 6 months after aSAH (modified Rankin scale > 3).
resultsIn the final cohort (n= 582), the rate of cerebral infarction, in-hospital mortality, and unfavorable outcome was 35.1%, 8.1%, and 17.6% respectively. The risk of cerebral infarction was independently related to the presence of acute hydrocephalus (adjusted odds ratio [aOR]=2.33, p<0.0001), aneurysm clipping (aOR=1.78, p=0.003), and use of calcium channel blockers concomitant to nimodipine (aOR=2.63, p=0.002). Patients' age (>55 years, aOR=4.24, p<0.0001), acute hydrocephalus (aOR=2.43, p=0.036), and clipping (aOR=2.86, p=0.001) predicted in-hospital mortality. Baseline characteristics associated with unfavorable outcome at 6 months were age (aOR=2.77, p=<0.0001), Fisher grades III-IV (aOR=2.81, p=0.016), acute hydrocephalus (aOR=2.22, p=0.012), clipping (aOR=3.98, p<0.0001), admission C-reactive protein>1mg/dL (aOR=1.76, p=0.035), and treatment intervals (aOR=0.64 per-5-year-intervals, p=0.006).
conclusionsAlthough cerebral infarction is a common complication in aSAH individuals with favorable initial clinical condition, >80% of these patients show favorable long-term outcome. The knowledge of outcome-relevant baseline characteristics might help to reduce the burden of further complications and poor outcome in aSAH patients who tolerated the initial bleeding event well.
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