{"title":"Aneurysmal subarachnoid hemorrhage in elderly patients: fluctuations in serum sodium levels were associated with poor neurological outcomes","authors":"Wataru Uchida, Tomoya Kamide, Kouichi Misaki, Daisuke Wajima Sho Takata, Mitsutoshi Nakada","doi":"10.1016/j.jocn.2025.111370","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics and treatment outcomes of aneurysmal subarachnoid hemorrhage (aSAH) in elderly (aged ≥75 years) and nonelderly patients (<75 years).</div></div><div><h3>Methods</h3><div>This single-center retrospective study enrolled 59 patients with aSAH between November 2019 and November 2023. Patients were categorized into elderly and nonelderly groups based on a cutoff of 75 years, with further subdivisions of the elderly group based on the modified Rankin Scale (mRS) score at discharge into favorable (mRS score 0–3) and poor (mRS score 4–6) outcomes. Clinical data, including the World Federation of Neurosurgical Societies (WFNS) grade, aneurysm size, and various clinical and laboratory parameters, were analyzed.</div></div><div><h3>Results</h3><div>The elderly group exhibited higher mRS scores 4–6 and larger aneurysms. Univariate and multivariate analyses identified fluctuating serum sodium levels as a significant predictor of poor neurological outcomes (P = 0.048) in elderly patients. The receiver operating characteristic curve of serum sodium variability showed a cutoff value of 10 mEq/L for good neurological outcomes (sensitivity, 84.6 %; specificity, 66.7 %; area under the curve, 0.87).</div></div><div><h3>Conclusions</h3><div>Elderly patients with aSAH typically present with more severe symptoms, which contribute to poorer outcomes, and larger aneurysms. However, stabilizing serum sodium fluctuations during treatment could improve the prognosis, emphasizing the need for careful perioperative management.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111370"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Neuroscience","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S096758682500342X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To investigate the clinical characteristics and treatment outcomes of aneurysmal subarachnoid hemorrhage (aSAH) in elderly (aged ≥75 years) and nonelderly patients (<75 years).
Methods
This single-center retrospective study enrolled 59 patients with aSAH between November 2019 and November 2023. Patients were categorized into elderly and nonelderly groups based on a cutoff of 75 years, with further subdivisions of the elderly group based on the modified Rankin Scale (mRS) score at discharge into favorable (mRS score 0–3) and poor (mRS score 4–6) outcomes. Clinical data, including the World Federation of Neurosurgical Societies (WFNS) grade, aneurysm size, and various clinical and laboratory parameters, were analyzed.
Results
The elderly group exhibited higher mRS scores 4–6 and larger aneurysms. Univariate and multivariate analyses identified fluctuating serum sodium levels as a significant predictor of poor neurological outcomes (P = 0.048) in elderly patients. The receiver operating characteristic curve of serum sodium variability showed a cutoff value of 10 mEq/L for good neurological outcomes (sensitivity, 84.6 %; specificity, 66.7 %; area under the curve, 0.87).
Conclusions
Elderly patients with aSAH typically present with more severe symptoms, which contribute to poorer outcomes, and larger aneurysms. However, stabilizing serum sodium fluctuations during treatment could improve the prognosis, emphasizing the need for careful perioperative management.
期刊介绍:
This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology.
The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.