Marcia Harumy Yoshikawa, Nícollas Nunes Rabelo, João Paulo Mota Telles, Guilherme Bitencourt Barbosa, Natália Camargo Barbato, Antônio Carlos Samaia da Silva Coelho, Leonardo Zumerkorn Pipek, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
{"title":"显微手术与栓塞:影响动脉瘤破裂患者短期和长期预后的不同危险因素。","authors":"Marcia Harumy Yoshikawa, Nícollas Nunes Rabelo, João Paulo Mota Telles, Guilherme Bitencourt Barbosa, Natália Camargo Barbato, Antônio Carlos Samaia da Silva Coelho, Leonardo Zumerkorn Pipek, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo","doi":"10.1590/acb370806","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH).</p><p><strong>Methods: </strong>Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS).</p><p><strong>Results: </strong>Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group.</p><p><strong>Conclusions: </strong>Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.</p>","PeriodicalId":6992,"journal":{"name":"Acta cirurgica brasileira","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708112/pdf/","citationCount":"0","resultStr":"{\"title\":\"Microsurgery versus embolization: different risk factors for short- and longterm outcomes of patients with ruptured aneurysms.\",\"authors\":\"Marcia Harumy Yoshikawa, Nícollas Nunes Rabelo, João Paulo Mota Telles, Guilherme Bitencourt Barbosa, Natália Camargo Barbato, Antônio Carlos Samaia da Silva Coelho, Leonardo Zumerkorn Pipek, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo\",\"doi\":\"10.1590/acb370806\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH).</p><p><strong>Methods: </strong>Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS).</p><p><strong>Results: </strong>Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group.</p><p><strong>Conclusions: </strong>Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.</p>\",\"PeriodicalId\":6992,\"journal\":{\"name\":\"Acta cirurgica brasileira\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708112/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta cirurgica brasileira\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1590/acb370806\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta cirurgica brasileira","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/acb370806","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
Microsurgery versus embolization: different risk factors for short- and longterm outcomes of patients with ruptured aneurysms.
Purpose: To evaluate the risk factors for poor outcomes after surgical and endovascular treatment of aneurysmal subarachnoid hemorrhage (aSAH).
Methods: Patients with ≥ 18-years of age and aSAH were included, while patients who died within 12 h of admission or lost follow-up were excluded. All participants underwent standardized clinical and radiological assessment on admission and were reassessed at discharge and at 6-months follow-up using the Glasgow Outcome Scale (GOS).
Results: Death at discharge was associated with female gender, anterior communication artery (ACoA) aneurysm location and presence of atherosclerotic plaque in the surgical group, and with age in the endovascular group. Both groups had clinical condition on follow-up associated with mFisher score on admission and hypertension. GOS on follow-up was also associated with presence of atherosclerotic plaque and multiple aneurysms in surgical group, and with age in endovascular group.
Conclusions: Subjects treated surgically are prone to unfavorable outcomes if atherosclerotic plaques and multiple aneurysms are present. In patients with endovascular treatment, age was the main predictor of clinical outcome.