Introduction: Objective: Data is scarce on long-term outcome after aneurysmal subarachnoid hemorrhage (SAH) in individuals aged = 70 years, despite the particularly high incidence of SAH. We therefore assessed outcome and 10 years’ survival in people aged = 70 years.
Methods: We retrospectively studied122 individuals aged =70 years (median 74.3, range 70-85 years, 70 % females) with aneurysmal SAH admitted 1996-2004. Ninety-six patients had the ruptured aneurysm repaired (surgical management). Twenty-six patients had no repair (non-surgical), 14 of whom on grounds of chronological age alone.
Results: Survival: Ninety-day’ mortality in surgical patients was 21/96 (22%; CI95: 14-32 %), and in non-surgical ones 22/26 (86%; CI95: 65-96%). 27 patients were alive by June 30th, 2013, having survived mean 11.8 years (range 9.2-17.5 years) after SAH.
The 14 patients who on grounds of age alone had no aneurysm repair, were 3 years older than the surgical patients, with fewer expected remaining life-years (p=0.044). Yet they lost a further 3.5 life-years from SAH (p=0.015).
Functional: Median 30 months after SAH, all survivors (n=67) were invited to participate in the study. The return rate for the self-administered health status questionnaires was 91 %. 73% of the respondents rated their current health as “good”, “very good” or “excellent”; mRS scores of 0, 1 and 2 were reported by 70%; 77% had Barthel ADL-scores of 90 or more; 77% reported living independently at home; whereas 78% could use public transportation.
Conclusions: Discussion/conclusion: Patient age may substantially influence treatment decisions. Without aneurysm repair, the prognosis for elderly people is dismal. Following repair, most survivors seem to have satisfactory outcomes. We believe that individuals aged = 70 years should not be denied aneurysm repair on grounds of chronological age alone.
Patient Care: Emphasize active management including aneurysm repair, and discourage therapeutic nihilism as concerns elderly people with SAH.
Learning Objectives: A substantial proportion of people aged > 70 do recover from SAH and aneurysm repair, and go on to live a further 10 years or more.