title: Management of elderly patients with aneurysmal subarachnoid hemorrhage.
abstract: A total of 299 patients with aneurysmal subarachnoid hemorrhage (SAH) were classified into three age groups, that is, those aged 59 years or younger (Group 1: 159 patients, 53%), those aged 60 to 69 years (Group 2: 85 patients, 28%), and those aged 70 years or older (Group 3: 55 patients, 18%). A comparison was made of the surgical indications and their overall management outcome in these age groups. The overall outcome at 1 year after SAH of Group 3 was significantly poorer than that of Group 1 (p less than 0.01) or Group 2 (p less than 0.01), but no significant difference could be demonstrated between Groups 1 and 2. Overall, 104 of the 299 patients died, for a mortality rate of 35%. The mortality rate by age group was 29% for Group 1, 33% for Group 2, and 55% for Group 3. Surgery was performed on 122 patients (77%) in Group 1, 56 (66%) in Group 2, and 25 (45%) in Group 3. The overall operative outcome at 1 year after SAH in Group 3 was significantly poorer than that of Group 1 (p less than 0.01), but no significant difference was observed in this regard between Groups 1 and 2. The operative mortality rate of the patients in Groups 1, 2, and 3 who were preoperatively in Hunt and Hess Grades I and II was 1%, 7%, and 22%, respectively (no significant difference). By life-table analysis the 5-year survival probability was 65% for Group 1, 60% for Group 2, and 37% for Group 3. The rate of patients surviving in good condition or in a disabled but independent condition at 1 year after SAH was 93% and no statistically significant difference in survival probability was observed among the three age groups.
authors.affiliation: Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Inagawa
authors.forename: M
authors.initials: M
authors.lastname: Yamamoto
authors.forename: K
authors.initials: K
authors.lastname: Kamiya
authors.forename: H
authors.initials: H
authors.lastname: Ogasawara
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*