title: Elderly age associated with poor functional outcome after rupture of anterior communicating artery aneurysms.
abstract: The effect of age on patient outcomes after rupture of the anterior communicating artery (Acom) aneurysms is not well-defined. We performed a retrospective cohort study of patients presenting to our institution with a ruptured Acom aneurysm between 2003 and 2012. Patients were divided into two groups on the basis of age at presentation, with patients 65years and older categorized as the elderly group. The effect of elderly age on patient outcomes was then evaluated using multivariate logistic regression analysis. There were 147 patients presenting with a ruptured Acom aneurysm. Of these, 41 (27.9%) were 65years or older. Patients in the elderly group were more likely to be female (68.3% vs. 40.6%, p=0.0026), and less likely to be active smokers (22.0% vs. 60.4%, p<0.0001) or to abuse alcohol (7.3% vs. 21.7%, p=0.0404). Elderly patients were more likely to have a history of hypertension (70.7% vs. 52.8%, p=0.0487) and coronary artery disease (19.5% vs. 2.8%, p=0.0006). Elderly patients were more likely to require a ventriculostomy (61.0% vs. 37.7%, p=0.0109) and ultimately to require permanent cerebrospinal fluid diversion (36.6% vs. 17.0%, p=0.0106). On adjusted analysis, age 65 years or older was associated with a greater likelihood of poor outcome at last follow-up within 1year of aneurysmal subarachnoid hemorrhage (odds ratio=3.76, 95% confidence interval: 1.30-11.78, p=0.0144). Our results suggest that elderly age is an independent risk factor for poor functional outcome after rupture of an Acom aneurysm.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, College of Medicine, 200 1st St SW, Rochester, MN 55905, USA. Electronic address: Rinaldo.Lorenzo@mayo.edu.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rinaldo
authors.affiliation: Department of Neurocritical Care, Mayo Clinic, Rochester, MN, USA.
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
authors.affiliation: Department of Neurosurgery, Mayo Clinic, College of Medicine, 200 1st St SW, Rochester, MN 55905, USA; Department of Neurointerventional Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lanzino
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology
keywords: Aneurysmal subarachnoid hemorrhage; Anterior communicating artery aneurysm; Elderly; Outcomes assessment