title: Level of consciousness and age as prognostic factors in aneurysmal SAH.
abstract: The prognostic value of the level of consciousness and the patient's age for the outcome of aneurysmal subarachnoid haemorrhage (SAH) is studied in 74 patients admitted on day (D) 0 to D3 after aneurysm rupture. For the level of consciousness three groups of patients are compared: grade I+II (alert patients), grade III+IV (drowsy patients), and grade V (comatose patients). For the age, two groups are compared: patients aged under 50, and patients aged 50 and over. The timing of surgery was: D0-D3 51%, D4-D6 20%, D7 and later 18%, and No surgery 11%. The overall management results were: Good (satisfactory result) 43%, Fair (moderately disabled) 18%, Poor (severely disabled+vegetative survival) 19%, and Death 20%. The outcome was strongly related to the level of consciousness, the rates of Good result decreasing from 71% (grades I-II) to 14% (grades III-IV) and to zero (grade V), and the mortality rates increasing respectively from 5% to 14% and 61%. The relationship between outcome and age was less marked: 54% Good result under 50 and 30% over 50. Out of the Grade V group, 56% could be operated upon and 44% died before surgery. No patient from the other two groups died before surgery. The literature concerning the Grading Systems published so far and the various prognostic factors are discussed.
authors.affiliation: Hôpital Neurologique et Neuro-chirurgical, Lyon, France.
authors.forename: R
authors.initials: R
authors.lastname: Deruty
authors.forename: I
authors.initials: I
authors.lastname: Pelissou-Guyotat
authors.forename: C
authors.initials: C
authors.lastname: Mottolese
authors.forename: D
authors.initials: D
authors.lastname: Amat
authors.forename: L
authors.initials: L
authors.lastname: Bognar
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000401:mortality* / Q000601:surgery; D001925:Brain Damage, Chronic / Q000145:classification / Q000401:mortality / Q000601:surgery; D003128:Coma / Q000145:classification / Q000401:mortality*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000145:classification / Q000401:mortality*; D011379:Prognosis; D013345:Subarachnoid Hemorrhage / Q000401:mortality* / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors