Age-Related Differences in Clinical Characteristics and Outcomes of Aneurysmal Subarachnoid Hemorrhage: A Retrospective Study of 657 Patients.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Min Jeoung Kim, Sun Yoon, Sang Kyu Park, Keun Young Park, Joonho Chung, Yong Bae Kim
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引用次数: 0

Abstract

Background: Aneurysmal subarachnoid hemorrhage (aSAH) has an incidence of 6-7 per 100,000 person-years. Despite advancements in treatment, 26% of patients die and 19% remain dependent after hemorrhage. Long-term neuropsychological sequelae affect about half of the survivors, significantly affecting their quality of life. This study aims to assess aSAH characteristics and identify predictive factors of clinical outcomes in young patients.

Methods: A retrospective study analyzed 657 patients with aSAH treated at 2 South Korean medical centers from January 2011 to December 2023. Data on demographics, comorbidities, smoking history, clinical grades, aneurysm size and location, and outcomes were collected. Outcomes were classified using the modified Rankin Scale, with scores ≤2 indicating good outcomes.

Results: The cohort included 233 men and 424 women (male/female ratio 1:1.8). Most patients were middle-aged (74.4%), followed by young (16.7%) and old (8.8%) groups. Young patients showed male predominance (56.8%), lower hypertension (12.7%) and diabetes (1.8%) rates, and higher smoking rates (39.6%). Older patients had higher hypertension (44.6%) and diabetes (23.3%) rates and were predominantly female (69.1%). Aneurysms in young patients were smaller (P = 0.04). Multivariate analysis identified poor Hunt-Hess grade, permanent cerebral infarction, and aneurysmal recurrence or rebleeding as predictors of poor outcomes in young patients. Middle-aged patients had additional predictors, including diabetes and hydrocephalus. In older patients, only poor Hunt-Hess grade was significant.

Conclusions: Young patients with aSAH show distinct characteristics and prognostic factors compared with older patients. Despite higher postoperative complications, young patients generally have better outcomes, emphasizing the need for age-specific management strategies in aSAH.

动脉瘤性蛛网膜下腔出血临床特征和预后中与年龄有关的差异:657 例患者的回顾性研究。
背景:动脉瘤性蛛网膜下腔出血(aSAH动脉瘤性蛛网膜下腔出血(aSAH)的发病率为每 10 万人年 6-7 例。尽管治疗手段不断进步,但仍有 26% 的患者死亡,19% 的患者在出血后仍需依靠药物维持生命。大约一半的幸存者会出现长期神经心理后遗症,严重影响他们的生活质量。本研究旨在评估急性脑出血的特征,并确定年轻患者临床结局的预测因素:这项回顾性研究分析了 2011 年 1 月至 2023 年 12 月期间在韩国两家医疗中心接受治疗的 657 名 aSAH 患者。研究收集了有关人口统计学、合并症、吸烟史、临床分级、动脉瘤大小和位置以及预后的数据。结果采用改良Rankin量表(mRS)进行分类,得分≤2表示预后良好:研究对象包括233名男性和424名女性(男女比例为1:1.8)。大多数患者为中年人(74.4%),其次是年轻人(16.7%)和老年人(8.8%)。年轻患者以男性为主(56.8%),高血压(12.7%)和糖尿病(1.8%)发病率较低,吸烟率较高(39.6%)。老年患者的高血压(44.6%)和糖尿病(23.3%)发病率较高,且以女性为主(69.1%)。年轻患者的动脉瘤较小(P=0.04)。多变量分析发现,Hunt-Hess分级较差、永久性脑梗塞、动脉瘤复发或再出血是年轻患者预后较差的预测因素。中年患者的其他预测因素包括糖尿病和脑积水。在老年患者中,只有较差的Hunt-Hess分级具有重要意义:结论:与老年患者相比,年轻的 aSAH 患者表现出不同的特征和预后因素。尽管术后并发症较高,但年轻患者的预后一般较好,这强调了针对不同年龄段的 aSAH 管理策略的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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