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  • Elderly Age Associated With Poor Functional Outcome After Rupture of Anterior Communicating Artery Aneurysms

    Final Number:
    1105

    Authors:
    Lorenzo Rinaldo MD, PhD; Giuseppe Lanzino MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Increasing age is known to be a risk factor for poor functional outcome after aneurysmal subarachnoid hemorrhage. The effect of age on patient outcomes specifically after rupture of anterior communicating artery (Acom) aneurysms is less well-defined.

    Methods: We performed retrospective cohort study on patients presenting to our institution with aneurysmal subarachnoid hemorrhage (aSAH) secondary to a ruptured Acom aneurysm between the years of 2003 and 2012. Patients were divided into two groups on the basis of age, with patients 65 years and older categorized as the elderly group. The effect of age on patient outcomes was then evaluated using multivariate logistic regression analysis.

    Results: There were 147 patients that presented to our institution with a ruptured Acom aneurysm. Of these patients, 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 CSF diversion (36.6% vs 17.0%, p = 0.0106). On adjusted analysis, age greater than 65 was associated with a greater likelihood of poor outcome at last follow-up within one year of aSAH (OR 3.76, 95% CI 1.30-11.78, p = 0.0144).

    Conclusions: Our results suggest that age greater than 65 is an independent risk factor for poor functional outcome after rupture of an Acom aneurysm. These findings provide valuable prognostic information for elderly patients presenting with a ruptured aneurysm at this location.

    Patient Care: Our study provides prognostic information for elderly patients with rupture of an anterior communicating artery aneurysm.

    Learning Objectives: To determine the effect of old age on patient outcomes after rupture of anterior communicating artery aneurysms

    References:

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