title: Results of clipping surgery for aneurysmal subarachnoid hemorrhage in the ninth and tenth decades of life.
abstract: This study investigated the outcome of clipping surgery for ruptured aneurysms in patients older than 80 years of age. From 1988 to 2011 data were retrospectively reviewed, and 196 patients treated with clipping obliteration for aneurysmal subarachnoid hemorrhage were identified. Patients were divided into two age groups of 80-84 and ⩾ 85 years old. The Glasgow Outcome Scale score was assessed at discharge and classified as favorable (good recovery or moderate recovery) or unfavorable (severe disability, vegetative state, or dead). Radiological and clinical characteristics were compared between the two groups. A favorable outcome was achieved in 106 (54.1%) of the 196 patients. Preoperative grade and Fisher grade were significantly associated with unfavorable outcome, but age was not. Based on logistic regression analysis, poor preoperative grade and ruptured anterior cerebral artery aneurysm were the predictors of unfavorable outcome, but advanced age (⩾ 85 years old) was not. Advanced age itself did not affect the outcome of the elderly patients who underwent clipping surgery for aneurysmal subarachnoid hemorrhage.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan. Electronic address: tetuyosi@shinshu-u.ac.jp.
authors.forename: Tetsuyoshi
authors.initials: T
authors.lastname: Horiuchi
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hongo
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D019635:Neurosurgical Procedures; D011859:Radiography; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cerebral aneurysm; Clipping; Elderly; Subarachnoid hemorrhage; Surgery