Sunday, January 13, 2013

Long-term outcome in Surviving patients after clipping of intracranial aneurysms

Available online 10 January 2013
Publication year: 2013
Source:World Neurosurgery

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 one year after their discharge were studied. Preoperative factors such as age, Hunt & Hess grade, Fisher scale, time interval between ictus and surgery and site of aneurysm were recorded. The long term status was assessed by 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, MRS and BI. 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 correalation 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 favourable in many. However, a substantial subset had impaired cognitive function.






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