Effect of non-neurological complications on the functional outcome of patients with ruptured intracranial aneurysms

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2025-04-03 DOI:10.1016/j.neuchi.2025.101663

Diego A. Ortega Moreno, Ibrahim Almulhim, Jerry C. Ku, Nicole Cancelliere, Danilo B. Diestro, Julian Spears, Vitor Mendes Pereira

{"title":"Effect of non-neurological complications on the functional outcome of patients with ruptured intracranial aneurysms","authors":"Diego A. Ortega Moreno, Ibrahim Almulhim, Jerry C. Ku, Nicole Cancelliere, Danilo B. Diestro, Julian Spears, Vitor Mendes Pereira","doi":"10.1016/j.neuchi.2025.101663","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening pathology associated with significant neurological and non-neurological complications. While the impact of neurological factors has been extensively studied, the impact of non-neurological complications remains underexplored. This study aimed to assess the effect of non-neurological complications on hospital stay and functional outcomes of patients with ruptured intracranial aneurysms (IAs).</div></div><div><h3>Methods</h3><div>A retrospective cohort study assessed patients with ruptured IAs treated within a neurovascular program of a tertiary hospital between October 2019 and September 2023. Inclusion criteria were: ≥18 years old, confirmed aSAH, and available follow-up information. The primary outcome corresponded to non-excellent functional outcomes at 6- and 12-month follow-ups. Secondary outcomes included length of in-hospital and intensive care unit (ICU) stay. Multivariate logistic regression models, adjusted for age, sex, and baseline World Federation of Neurosurgical Societies (WFNS) scores, were conducted.</div></div><div><h3>Results</h3><div>A total of 220 patients were included in this study, with a mean age of 56.66 ± 13.79 years; 74.5% were female. The most prevalent non-neurological complications were isolated fever (56.4%), arrhythmias (44.1%), and urinary tract infections (38.6%). Patients with poor neurological presentation had a higher prevalence of non-neurological complications. Pneumonia, pulmonary embolism, hyperglycemia, as well as fever were associated with higher odds of non-excellent functional outcomes (mRS 2–6) at 6- and 12-month follow-ups.</div></div><div><h3>Conclusions</h3><div>Non-neurological complications significantly impact hospital stay and functional recovery in aSAH patients. Early diagnosis and intervention, as well as the implementation of comprehensive clinical algorithms, are crucial for improving long-term outcomes in patients with ruptured IAs.</div></div>","PeriodicalId":51141,"journal":{"name":"Neurochirurgie","volume":"71 3","pages":"Article 101663"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurochirurgie","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0028377025000360","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening pathology associated with significant neurological and non-neurological complications. While the impact of neurological factors has been extensively studied, the impact of non-neurological complications remains underexplored. This study aimed to assess the effect of non-neurological complications on hospital stay and functional outcomes of patients with ruptured intracranial aneurysms (IAs).

Methods

A retrospective cohort study assessed patients with ruptured IAs treated within a neurovascular program of a tertiary hospital between October 2019 and September 2023. Inclusion criteria were: ≥18 years old, confirmed aSAH, and available follow-up information. The primary outcome corresponded to non-excellent functional outcomes at 6- and 12-month follow-ups. Secondary outcomes included length of in-hospital and intensive care unit (ICU) stay. Multivariate logistic regression models, adjusted for age, sex, and baseline World Federation of Neurosurgical Societies (WFNS) scores, were conducted.

Results

A total of 220 patients were included in this study, with a mean age of 56.66 ± 13.79 years; 74.5% were female. The most prevalent non-neurological complications were isolated fever (56.4%), arrhythmias (44.1%), and urinary tract infections (38.6%). Patients with poor neurological presentation had a higher prevalence of non-neurological complications. Pneumonia, pulmonary embolism, hyperglycemia, as well as fever were associated with higher odds of non-excellent functional outcomes (mRS 2–6) at 6- and 12-month follow-ups.

Conclusions

Non-neurological complications significantly impact hospital stay and functional recovery in aSAH patients. Early diagnosis and intervention, as well as the implementation of comprehensive clinical algorithms, are crucial for improving long-term outcomes in patients with ruptured IAs.

查看原文本刊更多论文

非神经系统并发症对颅内动脉瘤破裂患者功能预后的影响

背景：动脉瘤性蛛网膜下腔出血（aSAH）是一种危及生命的病理，与显著的神经系统和非神经系统并发症相关。虽然神经系统因素的影响已被广泛研究，但非神经系统并发症的影响仍未得到充分探讨。本研究旨在评估非神经系统并发症对颅内动脉瘤破裂（IAs）患者住院时间和功能结局的影响。方法一项回顾性队列研究评估了2019年10月至2023年9月在某三级医院神经血管项目治疗的IAs破裂患者。纳入标准为：年龄≥18岁，确诊aSAH，并有随访信息。在6个月和12个月的随访中，主要结果与非优秀的功能结果相对应。次要结局包括住院时间和重症监护病房（ICU）住院时间。采用多变量logistic回归模型，调整年龄、性别和基线世界神经外科学会联合会（WFNS）评分。结果共纳入220例患者，平均年龄56.66±13.79岁；74.5%为女性。最常见的非神经系统并发症是孤立性发热（56.4%）、心律失常（44.1%）和尿路感染（38.6%）。神经系统表现差的患者非神经系统并发症的发生率较高。在6个月和12个月的随访中，肺炎、肺栓塞、高血糖和发烧与非优秀功能结局（mRS 2-6）的较高几率相关。结论非神经系统并发症对aSAH患者住院时间和功能恢复有显著影响。早期诊断和干预，以及实施全面的临床算法，对于改善IAs破裂患者的长期预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.