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Research Paper|Volume 12, Issue 8|pp 7207—7217

Dynamics of outcome after aneurysmal subarachnoid hemorrhage

Alexander Hammer1, Gholamreza Ranaie1, Eduard Yakubov1, Frank Erbguth2, Markus Holtmannspoetter3, Hans-Herbert Steiner1, Hendrik Janssen4
  • 1Department of Neurosurgery, Paracelsus Medical University, Nuremberg 90471, Bavaria, Germany
  • 2Department of Neurology, Paracelsus Medical University, Nuremberg 90471, Bavaria, Germany
  • 3Department of Neuroradiology, Nuremberg General Hospital, Nuremberg 90471, Bavaria, Germany
  • 4Department of Neuroradiology, Ingolstadt General Hospital, Ingolstadt 85049, Bavaria, Germany
Received: November 20, 2019Accepted: March 29, 2020Published: April 20, 2020
https://doi.org/10.18632/aging.103069

Copyright © 2020 Hammer et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

In this observational study, we analyzed and described the dynamics of the outcome after aneurysmal subarachnoid hemorrhage (SAH) in a collective of 203 cases. We detected a significant improvement of the mean aggregate modified Rankin Score (mRS) in every time interval from discharge to 6 months and up to 1 year. Every forth to fifth patient with potential of recovery (mRS 1-5) at discharge improved by 1 mRS point in the time interval from 6 month to 1 year (22.6%). Patients with mRS 3 at discharge had a remarkable late recovery rate (73.3%, p = 0.000085). Multivariate analysis revealed age ≤ 65 years (odds ratio 4.93; p = 0.0045) and “World Federation of Neurological Surgeons” (WFNS) grades I and II (odds ratio 4.77; p = 0.0077) as significant predictors of early improvement (discharge to 6 months). Absence of a shunting procedure (odds ratio 8.32; p = 0.0049) was a significant predictor of late improvement (6 months to 1 year), but not age ≤ 65 years (p = 0.54) and WFNS grades I and II (p = 0.92). Thus, late recovery (6 month to 1 year) is significant and independent from age and WFNS grade.