title: Long-term outcome in surviving patients after clipping of intracranial aneurysms.
abstract: OBJECTIVE
  The quality of life and functional outcome may be significantly impaired in patients of aneurysmal subarachnoid hemorrhage. The purpose of the present study was to assess the status of patients undergoing surgical clipping of intracranial aneurysms in a long-term follow-up and to identify factors affecting outcome.
  
  
  METHODS
  494 patients who underwent clipping of their intracranial aneurysms with a minimum follow-up of 1 year after their discharge were studied. Preoperative factors such as age, Hunt and Hess grade, Fisher grade, time interval between ictus and surgery, and site of aneurysm were recorded. The long-term status was assessed using Glasgow Outcome Scale (GOS), Modified Rankin Scale (MRS), Barthel index (BI), and Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Site of aneurysm and ictus-surgery interval did not have any effect on any parameter at long-term follow-up. Majority of patients who were discharged continued to improve as measured by GOS, Modified Rankin Scale, and Barthel index. However a significant proportion of patients had impaired MMSE at long-term follow-up. Multivariate analysis showed a significant effect of age on MMSE and also a positive correlation between number of aneurysms and GOS.
  
  
  CONCLUSIONS
  Most patients who survived and were discharged continued to improve in the postoperative period even though the immediate postoperative outcome was not favorable in many. However, a substantial subset had impaired cognitive function.
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: drguptasunil@gmail.com.
authors: Sunil Kumar
authors: SK
authors: Gupta
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Rajesh
authors: R
authors: Chhabra
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Sandeep
authors: S
authors: Mohindra
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Arpita
authors: A
authors: Sharma
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Suresh Narain
authors: SN
authors: Mathuriya
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Ashis
authors: A
authors: Pathak
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Manoj Kumar
authors: MK
authors: Tewari
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Kanchan Kumar
authors: KK
authors: Mukherji
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Navneet
authors: N
authors: Singla
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Praveen
authors: P
authors: Salunke
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Alok Arvind
authors: AA
authors: Umredkar
authors: Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Virender Kumar
authors: VK
authors: Khosla
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology* / Q000601:surgery*; D013525:Surgical Instruments; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Aneurysm clipping; Cognitive function; Long-term outcome; Subarachnoid hemorrhage