Evidence map›Paper›PMID 40445438›Full record

ArticleNeurosurgical review2025

Lack of association between chronological age and fisher group and poor outcomes in older patients with severe-grade aneurysmal subarachnoid hemorrhage: a nationwide registry study in Japan.

Kaima Suzuki, Hiroki Sato, Takatoshi Sorimachi, Hitoshi Fukuda, Tetsuya Ueba, Masaki Chin, Hirofumi Nakatomi, Yoshiaki Shiokawa, Tatsuya Ishikawa, Takakazu Kawamata and 9 more

Abstract read
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Article in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Kaima SuzukiDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
Hiroki SatoDepartment of Neurosurgery, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
Takatoshi SorimachiDepartment of Neurosurgery, Tokai University, Kanagawa, Japan.
Hitoshi FukudaDepartment of Neurosurgery, Kochi University, Kochi, Japan.
Tetsuya UebaDepartment of Neurosurgery, Kochi University, Kochi, Japan.
Masaki ChinDepartment of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.
Hirofumi NakatomiDepartment of Neurosurgery, Kyorin University School of Medicine, Tokyo, Japan.
Yoshiaki ShiokawaDepartment of Neurosurgery, Fuji Brain Institute and Hospital, Shizuoka, Japan.
Tatsuya IshikawaDepartment of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Takakazu KawamataDepartment of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Ichiro NakaharaDepartment of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Norihito ShimamuraDepartment of Neurosurgery, Hirosaki General Medical Center, Aomori, Japan.
Hiroki OhkumaDepartment of Neurosurgery, Hirosaki General Medical Center, Aomori, Japan.
Nao IchiharaDepartment of Medical Innovation, University of Osaka, Osaka, Japan.
Shota KakizakiDepartment of Neurosurgery, Atsugi City Hospital, Kanagawa, Japan.
Yuichi MurayamaDepartment of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan.
Kazunori ToyodaDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Hiroki KuritaDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
Fusao IkawaDepartment of Neurosurgery, Hiroshima University, Hiroshima, Japan. fikawa-nsu@umin.ac.jp.ORCID http://orcid.org/0000-0003-4205-1490

Funding

Japan Society for the Promotion of Science Grant-in-Aid for Scientific Research (C) 23K08521
6 · The paper itself

Abstract

Older age and Fisher group scores predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, among aging societies, treatment indications and decisions in older patients with severe-grade aSAH (World Federation of Neurosurgical Societies [WFNS] grade IV or V) remain poorly understood. Therefore, we aimed to identify the risk factors associated with poor outcomes in non-older and older patients with severe-grade aSAH. We analyzed a database of patients with aSAH treated between April 2007 and December 2019 in Japan and divided them into either the non-older (< 75 years) or older group (age ≥ 75 years) to identify factors associated with poor outcomes (modified Rankin Scale score [mRS] 3-6) at discharge. The data analyzed included patient demographics, comorbidities, aneurysm characteristics, Fisher group, WFNS grade, treatment method, and mRS score at discharge. Among the 5,095 patients, 1,303 (986 non-older and 317 older) were classified as having severe-grade aSAH. In non-older patients, chronological age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03-1.05) and Fisher groups 3 and 4 were associated with poor outcomes as compared with Fisher group 1 + 2 (OR, 2.98; 95% CI, 1.59-5.58 and OR, 5.49; 95% CI, 2.86-10.54, respectively). However, chronological age and Fisher groups 3 and 4 were not associated with poor outcomes in older patients with severe-grade aSAH. This study suggests that outcomes in older patients with severe-grade aSAH cannot be predicted in the same manner as in non-older patients. Further research on potential prognostic factors, such as biological age, is warranted. Clinical trial number Not applicable.

Indexed as

Subarachnoid HemorrhageAgedAged, 80 and overAge FactorsFemaleHumansJapanMaleMiddle AgedRegistriesRisk FactorsTreatment OutcomeAneurysmal subarachnoid hemorrhageAneurysm ruptureChronological ageFisher groupHypertensionOlder

Identifiers

PMID40445438

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.