METHODS: Data were extracted from a prospective nationwide multicenter study performed in September 2014 to March 2018. Glasgow Outcome Scale Extended (GOSE) grade, 1-year mortality, and survival probability were assessed at one year after ictus. Logistic univariate, multivariate, and Cox regression analyses were used to study the variables\' associations with the outcomes.
RESULTS: Unfavorable dichotomized GOSE (dGOSE; grades 1-4) was observed in 35.4% of patients. Microsurgery was preferred for middle cerebral artery aneurysms and Fisher grade 4. Treatment modality was not associated with any outcome measure. Dichotomized World Federation of Neurosurgical Societies (dWFNS), age, and delayed ischemic neurological deficit (DIND) showed significant correlations with dGOSE and 1-year mortality in multivariate regression analyses. Pupil dilatation was associated with a 1-year mortality outcome. Cox regression analysis showed lower survival probability for pupil dilatation (hazard ratio [HR]: 3.546), poor dWFNS (HR: 3.688), higher age (HR: 1.051), and DIND occurrence (HR: 2.214).
CONCLUSIONS: The patient selection in Sweden after aneurysmal subarachnoidal hemorrhage showed similar values for dGOSE, 1-year mortality, and survival probability between patients treated with microsurgery or endovascular technique. Poor dWFNS, higher age, and DIND were significantly associated with unfavorable dGOSE, mortality, and survival probability. Pupil dilatation was significantly associated with mortality and survival probability.
方法:数据来自2014年9月至2018年3月进行的一项前瞻性全国多中心研究。格拉斯哥结果量表扩展(GOSE)等级,1年死亡率,和生存概率在一年后评估。Logistic单变量,多变量,和Cox回归分析用于研究变量与结局的关联。
结果:在35.4%的患者中观察到不利的二分GOSE(dGOSE;1-4级)。大脑中动脉动脉瘤和Fisher4级首选显微外科手术。治疗方式与任何结果指标无关。二分法世界神经外科学会联合会(dWFNS),年龄,在多因素回归分析中,迟发性缺血性神经功能缺损(DIND)与dGOSE和1年死亡率显著相关.瞳孔扩张与1年死亡率结局相关。Cox回归分析显示瞳孔扩张的生存概率较低(风险比(HR)3.546),差费(HR3.688),年龄较高(HR1.051),和DIND发生(HR2.214)。
结论:在瑞典,aSAH后的患者选择显示dGOSE值相似,1年死亡率,以及接受显微外科手术或血管内技术治疗的患者之间的生存概率。可怜的dWFNS,年龄较高,DIND与不良dGOSE显著相关,死亡率,和生存概率。瞳孔扩张与死亡率和生存概率显著相关。