Patient age and vasospasm after subarachnoid hemorrhage.
BACKGROUND
Subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm is a devastating disease with high mortality and morbidity. The incidence of SAH increases with advancing age.


OBJECTIVE
To determine whether age is an independent predictor of angiographic vasospasm, delayed ischemic neurological deficits (DINDs), or abnormal transcranial Doppler (TCD) measurements in patients with aneurysmal subarachnoid hemorrhage.


METHODS
Data from CONSCIOUS-1 (Clazosentan to Overcome Neurological Ischemia and Infarct Occurring After Subarachnoid Hemorrhage study), a dose-finding study of clazosentan, were used. Data on angiographic vasospasm, DINDs, and TCD abnormalities were prospectively recorded as well as baseline characteristics and treatment data. Patient age was considered in 3 ways: as a continuous variable, dichotomized at age 65 years, and categorized by decade. Age was investigated as the main variable, whereas other possible confounding variables were adjusted for in the multiple logistic regression modeling with each of 3 dichotomized vasospasm outcome measures, presence or absence of angiographic vasospasm, DINDs, and TCD abnormalities as the dependent variable.


RESULTS
The proportions of patients with angiographic vasospasm, DINDs, and TCD abnormalities were 45%, 19%, and 81%, respectively. Age, whether considered as a continuous, dichotomous, or a categorical variable, was not significantly associated with angiographic vasospasm, DINDs, or abnormal TCD measurements.


CONCLUSIONS
Age does not seem to be a significant predictor for cerebral vasospasm after subarachnoid hemorrhage.
Ryttlefors
Mats
M
Department of Neuroscience, Section for Neurosurgery, Uppsala University Hospital, Uppsala, Sweden. Mats.Ryttlefors@Neuro.uu.se
Enblad
Per
P
Ronne-Engström
Elisabeth
E
Persson
Lennart
L
Ilodigwe
Don
D
Macdonald
R Loch
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D015901:Angiography, Digital Subtraction / Q000379:methods; D004146:Dioxanes / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D007391:International Cooperation; D016015:Logistic Models; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D011237:Predictive Value of Tests; D011725:Pyridines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000188:drug therapy; D013449:Sulfonamides / Q000627:therapeutic use; D013777:Tetrazoles / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D020301:Vasospasm, Intracranial / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
D004146:Dioxanes; D011725:Pyridines; D011743:Pyrimidines; D013449:Sulfonamides; D013777:Tetrazoles; C109641:clazosentan