Subarachnoid hemorrhage in old patients in Chongqing China.
BACKGROUND
Subarachnoid hemorrhage (SAH) is a disorder with high mortality in central nervous system, especially in old population. Misdiagnosis and poor outcome frequently occur in old patients with SAH. This research is to investigate the demographic characteristics, clinical features, neuroimaging data, and the outcome of the old patients (≥60 of age) with SAH.


METHODS
The data was from both neurosurgical and neurology departments of two hospitals in Chongqing, China, from October 2007 to March 2009. One hundred and seventy eight patients were enrolled and divided into two groups: the elderly group (≥60 of age) and the non-elderly group (≥18 but <60 of age). The condition on admission was assessed by Hunt-Hess grade (H-H) and the Glasgow scales of coma (GCS). Findings on computerized tomography (CT) were measured by Fisher grades. The outcome after 3 months was evaluated by the modified Rankin Scale (mRS). Statistic analysis was managed by Chi-square test and t-test.


RESULTS
Compared to the non-elderly group, the clinical conditions on admission in the elderly group was worse, with lower average scores of GCS, higher Fisher grades, systolic blood pressure, and percentage of the H-H IV and V. Some preexisting medical conditions with the old such as arterial hypertension, pulmonary diseases, and diabetes mellitus were worsening. During the clinical course, the elderly group had the following characteristics: the incidence of rebleeding, asymptomatic vasospasm, hydrocephalus, and other severe medical complications were all higher, while the percentage of early surgery was lower. The outcome after 3 months was poorer in the elderly.


CONCLUSIONS
It is indicated that the elderly patients with SAH have poorer clinical conditions, much lower ratio of early surgery and higher incidence of rebleeding. Together, these factors contribute to a poorer short-term outcome after SAH.
Department of Neurology, the First Affiliated Hospital of Chongqing Medical University of Chongqing, Chongqing, 400016, People's Republic of China.
Yan
Y
Zhang
Tianzhu
T
Wang
John H
JH
Zhang
Jiayu
J
Zhang
Xinyue
X
Qin
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*; D016896:Treatment Outcome; D055815:Young Adult