Clinical Demographic Association and Outcome in Patients with Aneurysmal Subarachnoid Hemorrhage

• Main Authors: Mayank Bansal, R. S. Mittal
• Format: Article
• Language: English
• Published: Thieme Medical Publishers, Inc. 2015-07-01
• Series: Indian Journal of Neurosurgery
• Subjects: aneurysm; subarachnoid hemorrhage; clipping; hunt and hess grade
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1558966
• ISSN: 2277-954X; 2277-9167

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.