title: [Is hyperdynamic therapy possible for elderly patients with vasospasm following subarachnoid hemorrhage?].
abstract: BACKGROUND
  Recently we have an increased number of elderly patients with subarachnoid hemorrhage (SAH) to be treated. Elderly patients are expected to have a worse cardiac function than that of younger patients. A question arises whether management for elderly patients in the vasospasm period can be performed as safely as it is for younger patients. The aim of this study is to examine the cardiac function of the elderly patients (> or =75 y.o.) with SAH correlated with various complications in the vasospasm period.
  
  
  METHODS
  We retrospectively analyzed consecutive 356 patients with SAH encountered in our institute since 2000 to 2006. Seventy-three patients (20.5% of all) are 75 or more than 75-year-old. Their mean age is 80.4 +/- 4.43 (16 male, 57 female). Cardiac function was examined by trans-thoracic echocardiography (CTE) in 40 patients (54.8%).
  
  
  RESULTS
  Average value of their ejection fraction (EF) and rates of perioperative complications were not so different from those of the younger patients. But among patients of > or =75 y.o., certain patients in whom EF was under 0.6 significantly have experienced cardiopulmonary complications and longer hospitalization. In a multiple logistic analyses, only EF is significantly related with cardiopulmonary complications (P = 0.013).
  
  
  CONCLUSIONS
  Among elderly SAH patients > or =75 year of age, some have experienced more cardiopulmonary complications than younger patients and have needed longer hospitalization. For such patients hyperdynamic therapy must be carefully carried out. TTE is effective to predispose and help eliminate their cardiopulmonary complications in the pre- and postoperative period.
authors.affiliation: Department of Neurosurgery, Research Institute for Brain and Blood Vessels, Akita, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hikichi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Jyunta
authors.initials: J
authors.lastname: Moroi
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hanyu
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tamakawa
authors.forename: Norikata
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Hideya
authors.initials: H
authors.lastname: Kawai
authors.forename: Syotaro
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Yohei
authors.initials: Y
authors.lastname: Ohnaka
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Mutoh
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yasui
authors.forename: Akifumi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Manabu
authors.initials: M
authors.lastname: Izumi
authors.forename: Risako
authors.initials: R
authors.lastname: Fujiwara
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Ono
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology; D020301:Vasospasm, Intracranial / Q000150:complications / Q000503:physiopathology*