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Titolo:
Multivariate analysis of predictors of cerebral vasospasm occurrence afteraneurysmal subarachnoid hemorrhage
Autore:
Charpentier, C; Audibert, G; Guillemin, F; Civil, T; Ducrocq, X; Bracard, S; Hepner, H; Picard, L; Laxenaire, MC;
Indirizzi:
Univ Henri Poincare, Nancy Univ Hosp, Dept Anesthesiol, Nancy, France UnivHenri Poincare Nancy France Hosp, Dept Anesthesiol, Nancy, France Univ Henri Poincare, Nancy Univ Hosp, Dept Clin Epidemiol, UPRES EA 1124, Nancy, France Univ Henri Poincare Nancy France pidemiol, UPRES EA 1124, Nancy, France Univ Henri Poincare, Nancy Univ Hosp, Dept Neurosurg, Nancy, France Univ Henri Poincare Nancy France iv Hosp, Dept Neurosurg, Nancy, France Univ Henri Poincare, Nancy Univ Hosp, Dept Neurol, Nancy, France Univ Henri Poincare Nancy France Univ Hosp, Dept Neurol, Nancy, France Univ Henri Poincare, Nancy Univ Hosp, Dept Neuroradiol, Nancy, France UnivHenri Poincare Nancy France Hosp, Dept Neuroradiol, Nancy, France
Titolo Testata:
STROKE
fascicolo: 7, volume: 30, anno: 1999,
pagine: 1402 - 1408
SICI:
0039-2499(199907)30:7<1402:MAOPOC>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
RUPTURED INTRACRANIAL ANEURYSMS; ENDOVASCULAR TREATMENT; COOPERATIVE ANEURYSM; EARLY OPERATION; SURGERY; MANAGEMENT; ISCHEMIA; BLOOD; OCCLUSION; INSULTS;
Keywords:
cerebral vasospasm; endovascular therapy; prognosis; subarachnoid hemorrhage; surgical treatment;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
44
Recensione:
Indirizzi per estratti:
Indirizzo: Audibert, G Hop Cent, Dept Anesthesie, 29 Ave de Lattre de Tassigny, F-54000 Nancy, France Hop Cent 29 Ave de Lattre de Tassigny Nancy France F-54000 ce
Citazione:
C. Charpentier et al., "Multivariate analysis of predictors of cerebral vasospasm occurrence afteraneurysmal subarachnoid hemorrhage", STROKE, 30(7), 1999, pp. 1402-1408

Abstract

Background and Purpose-The role of type of treatment on cerebral vasospasmoccurrence after aneurysmal subarachnoid hemorrhage (SAH) has not been studied. Through multivariate analysis we determined the independent prognostic factors of the occurrence of symptomatic vasospasm following aneurysmal SAH in a study cohort of 244 patients undergoing either surgical or endovascular treatment. The prognostic factors of sequelae after aneurysmal SAH were studied as well. Methods-Symptomatic vasospasm was defined as the association of deterioration in a patient's neurological condition between 3 and 14 days after SAH with no other explanation and an increase in mean transcranial Doppler velocities of >120 cm/s, The prognostic factors were registered on admission andduring the intensive care stay,Results-Symptomatic vasospasm occurred in 22.2% surgical patients comparedwith 17.2% endovascular treatment patients (P=0.37). Multivariate analysisrevealed that the probability of occurrence of symptomatic vasospasm decreased with age >50 years (relative risk [RR], 0.47 [0.25 to 0.88]) and severe World Federation of Neurological Surgeons (WFNS) grade measured on admission (RR, 0.43 [0.20 to 0.90]) and increased with hyperglycemia occurring during the intensive care stay (RR, 1.94 [1.04 to 3.63]), No difference in risk of symptomatic vasospasm could be identified between surgical and endovascular treatment. Symptomatic vasospasm (OR, 4.73 [CI, 1.77 to 13.6]) as well as WFNS grade of >2 (OR, 8.95 [3.46 to 23.2]), treatment complications (OR, 8.39 [3.16 to 22.3]), and secondary brain insults were associated with an increased risk of 6-month sequelae,Conclusions-Age <50 years,good neurological grade, and hyperglycemia were all associated with an increased risk of cerebral vasospasm whereas treatment was not, This provides a basis for future clinical prospective randomized trials comparing both treatments.

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Documento generato il 28/09/20 alle ore 11:11:51