Introduction: The management of patients with poor-grade aneurismal subarachnoid hemorrhage (a SAH) remains controversial. The purpose was to examine factors of poor grade treated with either surgery or endovascular treatment depending on each patient's condition.
Methods: Between October 2010 and March 2012, Patients with a SAH of World Federation of Neurosurgical Societies (WFNS) grade IV or V in admission were enrolled in A multicenter Prospective Clinical Trail of Poor-grade of Aneurysmal SAH (AMPAS) at multiple centers in China. Patients were treated according to the preference of investigators who were experienced in performing both clipping and coiling. Factors influencing poor outcome (GOS 1-3) were determined using multivariate logistic regression analyses.
Results: There were 260 patients with WFNS grade IV (149 patients) and grade V (111 patients) in the cohort. 138 of 260 patients (53.08%) had a poor outcome (GOS 1-3), of whom 57 with grade IV, 81 with grade V. The average age was 54±11 years old, and the time of follow up was 6.90±2.48 months. According to logistic regression analyses, increasing age, preoperative GCS, discharge GOS significantly associated with poor outcome, although the admission WFNS did not affect poor outcome. Discharge GOS was associated with patient death.
Conclusions: More than half of patients with poor-grade of aneurysmal SAH had a poor outcome although patients were treated actively and lived a long time. Increasing age was found to be independent predictors of poor clinical outcome.
Patient Care: More than half of patients with poor-grade of aneurysmal SAH had a poor outcome although patients were treated actively and lived a long time. Increasing age was found to be independent predictors of poor clinical outcome.
Learning Objectives: We recommend using the format, "By the conclusion of this session, participants should be able to: 1) Describe the importance of A multicenter Prospective Clinical Trail of Poor-grade of Aneurysmal SAH (AMPAS) at multiple centers in China, 2) Discuss, Patients were treated according to the preference of investigators who were experienced in performing both clipping and coiling. Factors influencing poor outcome (GOS 1-3) were determined using multivariate logistic regression analyses,3) Identify More than half of patients with poor-grade of aneurysmal SAH had a poor outcome although patients were treated actively and lived a long time. Increasing age was found to be independent predictors of poor clinical outcome. "