Elderly age associated with poor functional outcome after rupture of anterior communicating artery aneurysms

Lorenzo Rinaldo, Alejandro Rabinstein, Giuseppe Lanzino

Research output: Contribution to journalArticle

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Abstract

The effect of age on patient outcomes after rupture of the anterior communicating artery (Acom) aneurysms is not well-defined. We performed a retrospective cohort study of patients presenting to our institution with a ruptured Acom aneurysm between 2003 and 2012. Patients were divided into two groups on the basis of age at presentation, with patients 65 years and older categorized as the elderly group. The effect of elderly age on patient outcomes was then evaluated using multivariate logistic regression analysis. There were 147 patients presenting with a ruptured Acom aneurysm. Of these, 41 (27.9%) were 65 years or older. Patients in the elderly group were more likely to be female (68.3% vs. 40.6%, p = 0.0026), and less likely to be active smokers (22.0% vs. 60.4%, p < 0.0001) or to abuse alcohol (7.3% vs. 21.7%, p = 0.0404). Elderly patients were more likely to have a history of hypertension (70.7% vs. 52.8%, p = 0.0487) and coronary artery disease (19.5% vs. 2.8%, p = 0.0006). Elderly patients were more likely to require a ventriculostomy (61.0% vs. 37.7%, p = 0.0109) and ultimately to require permanent cerebrospinal fluid diversion (36.6% vs. 17.0%, p = 0.0106). On adjusted analysis, age 65 years or older was associated with a greater likelihood of poor outcome at last follow-up within 1 year of aneurysmal subarachnoid hemorrhage (odds ratio = 3.76, 95% confidence interval: 1.30–11.78, p = 0.0144). Our results suggest that elderly age is an independent risk factor for poor functional outcome after rupture of an Acom aneurysm.

Original languageEnglish (US)
Pages (from-to)108-111
Number of pages4
JournalJournal of Clinical Neuroscience
Volume34
DOIs
StatePublished - Dec 1 2016

Fingerprint

Intracranial Aneurysm
Rupture
Ruptured Aneurysm
Ventriculostomy
Subarachnoid Hemorrhage
Alcoholism
Cerebrospinal Fluid
Coronary Artery Disease
Cohort Studies
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Confidence Intervals
Hypertension

Keywords

  • Aneurysmal subarachnoid hemorrhage
  • Anterior communicating artery aneurysm
  • Elderly
  • Outcomes assessment

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Elderly age associated with poor functional outcome after rupture of anterior communicating artery aneurysms. / Rinaldo, Lorenzo; Rabinstein, Alejandro; Lanzino, Giuseppe.

In: Journal of Clinical Neuroscience, Vol. 34, 01.12.2016, p. 108-111.

Research output: Contribution to journalArticle

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abstract = "The effect of age on patient outcomes after rupture of the anterior communicating artery (Acom) aneurysms is not well-defined. We performed a retrospective cohort study of patients presenting to our institution with a ruptured Acom aneurysm between 2003 and 2012. Patients were divided into two groups on the basis of age at presentation, with patients 65 years and older categorized as the elderly group. The effect of elderly age on patient outcomes was then evaluated using multivariate logistic regression analysis. There were 147 patients presenting with a ruptured Acom aneurysm. Of these, 41 (27.9{\%}) were 65 years or older. Patients in the elderly group were more likely to be female (68.3{\%} vs. 40.6{\%}, p = 0.0026), and less likely to be active smokers (22.0{\%} vs. 60.4{\%}, p < 0.0001) or to abuse alcohol (7.3{\%} vs. 21.7{\%}, p = 0.0404). Elderly patients were more likely to have a history of hypertension (70.7{\%} vs. 52.8{\%}, p = 0.0487) and coronary artery disease (19.5{\%} vs. 2.8{\%}, p = 0.0006). Elderly patients were more likely to require a ventriculostomy (61.0{\%} vs. 37.7{\%}, p = 0.0109) and ultimately to require permanent cerebrospinal fluid diversion (36.6{\%} vs. 17.0{\%}, p = 0.0106). On adjusted analysis, age 65 years or older was associated with a greater likelihood of poor outcome at last follow-up within 1 year of aneurysmal subarachnoid hemorrhage (odds ratio = 3.76, 95{\%} confidence interval: 1.30–11.78, p = 0.0144). Our results suggest that elderly age is an independent risk factor for poor functional outcome after rupture of an Acom aneurysm.",
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