年龄对世界神经外科学会联合会 I 级和 II 级动脉瘤性蛛网膜下腔出血手术结果的影响:使用递归分区分析的新型预后模型。

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Motoyuki Umekawa, Gakushi Yoshikawa
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引用次数: 0

摘要

本研究旨在评估年龄这一预后因素,并为接受世界神经外科学会联合会(WFNS)I/II级动脉瘤性蛛网膜下腔出血(SAH)夹闭手术的患者建立一个综合预后模型。我们对 2010 年 12 月至 2020 年 1 月期间在我院接受显微外科夹闭手术的 188 例 WFNS I/II 级 SAH 患者进行了回顾性调查。我们分析了 176 名患者(75 名 I 级患者和 101 名 II 级患者)的数据。收集的数据包括患者人口统计学特征、动脉瘤特征、SAH因素、手术细节和临床结果。采用双变量和多变量逻辑回归分析以及递归分区分析对预后因素进行了评估。76%的患者预后良好(mRS 0-2)。在多变量分析中,年龄是一个重要的负面预后因素(几率比0.55,95%置信区间0.40-0.76,p 70岁(分别为84%和46%;p 70岁))。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of age on surgical outcomes for world federation of neurosurgical societies grade I and II aneurysmal subarachnoid haemorrhage: a novel prognostic model using recursive partitioning analysis.

This study aimed to evaluate age as a prognostic factor and develop a comprehensive prognostic model for patients undergoing clipping surgery for World Federation of Neurosurgical Societies (WFNS) grade I/II aneurysmal subarachnoid haemorrhage (SAH). We retrospectively investigated 188 patients with WFNS grade I/II SAH who underwent microsurgical clipping at our institute between December 2010 and January 2020. The data of 176 patients (75 with grade I and 101 with grade II) were analysed. Data on patient demographics, aneurysm characteristics, SAH factors, surgical details, and clinical outcomes were collected. Prognostic factors were assessed using bivariate and multivariable logistic regression analyses, and recursive partitioning analysis. Favourable outcomes (mRS 0-2) were observed in 76% of patients. Age, a significant negative prognostic factor in multivariable analysis (odds ratio 0.55, 95% confidence interval 0.40-0.76, p < 0.001), was cutoff at 70 years by the receiver operating characteristic curve. Patients aged ≤ 70 years had significantly better outcomes than those aged > 70 years (84% vs. 46%, respectively; p < 0.001). Epileptic seizures were significantly associated with poor outcomes in older adults (p < 0.001). A prognostic model (favourable, intermediate, and poor) based on age and postoperative adverse events showed significantly different outcomes between age groups (p < 0.001). Age was a stronger prognostic factor than WFNS grading for patients with grade I/II SAH undergoing microsurgical clipping. For patients aged ≤ 70 years, precise microsurgeries with fewer complications were associated with favourable outcomes beyond WFNS grade. For older patients, postoperative intensive seizure management may prevent poor outcomes.

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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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