Author(s): Vergouwen MD, Fang J, Casaubon LK, Stamplecoski M, Robertson A
Background and purpose: After aneurysmal subarachnoid hemorrhage (SAH), patients with clipped aneurysms have a higher incidence of neurocognitive deficits and seizures compared with patients with coiled aneurysms. It remains unknown if patients with clipped aneurysms also have a higher incidence of other in-hospital complications.
Methods: We used data from the Registry of the Canadian Stroke Network on consecutive patients admitted to hospital with aneurysmal SAH. Patients who died within 2 days after admission were excluded. Baseline characteristics, incidence of various in-hospital complications within 30 days after admission, length of stay, poor functional outcome (modified Rankin Scale score at discharge of ≥3), and mortality were compared between patients with clipped versus coiled aneurysms.
Results: Of the 931 patients, 548 (59%) were clipped and 383 (41%) coiled. Baseline characteristics were similar. Compared with patients with coiled aneurysms, patients with clipped aneurysms had a higher incidence of in-hospital complications (37.2% versus 24.5% of patients; P<0.0001), poor functional outcome at discharge (69.4% versus 51.4%; P<0.0001), mortality (at discharge: 14.6% versus 9.1%; P=0.01), and a longer length of stay (17 [interquartile range, 11 to 29] versus 13 [interquartile range, 7 to 22] days; P<0.0001). Higher incidences were observed for urinary tract infection (P=0.02), pneumonia (P=0.01), cardiac/respiratory arrest (P=0.007), seizure (P=0.01), and decubitus ulcer (P=0.02). Urinary tract infection, pneumonia, cardiac/respiratory arrest, and seizure were independent predictors of poor functional outcome.
Conclusions: Patients with clipped aneurysms have a higher incidence of in-hospital complications than patients with coiled aneurysms, which attributes to a higher risk of poor functional outcome and death and an increased length of stay.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/21868732
Author(s): Schievink WI
Author(s): Choi SS, Jeon SJ
Author(s): Zubair Tahir M, Enam SA, Pervez Ali R, Bhatti A, ul Haq T
Author(s): Natarajan SK, Sekhar LN, Ghodke B, Britz GW, Bhagawati D, et al.
Author(s): de Oliveira JG, Beck J, Ulrich C, Rathert J, Raabe A, et al.
Author(s): Im SH, Han MH, Kwon OK, Kwon BJ, Kim SH, et al.
Author(s): Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, et al.
Author(s): Hamid RS, Haq T, Chishti I, Azeemuddin M, Sajjad Z, Salam B
Author(s): Wijdicks EF, Kallmes DF, Manno EM, Fulgham JR, Piepgras DG
Author(s): Johnston SC, Selvin S, Gress DR
Author(s): Soni D
Author(s): Li H, Pan R, Wang H, Rong X, Yin Z, et al.
Author(s): Lanzino G, Murad MH, dUrso PI, Rabinstein A
Author(s): Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M et al.
Author(s): Dorhout Mees SM, Kerr RS, Rinkel GJ, Algra A, Molyneux AJ
Author(s): Lindsay KW, Bone I, Fuller G, Callander R, Gijin JV
Author(s): J Lafuente, Maurice-Williams RS
Author(s): Frosch MP, Anthony DC, Girolami UD
Author(s): Darsaut TE, Kotowski M, Raymond J
Author(s): Platt ML, Huettel SA
Author(s): Hoh BL, Chi YY, Dermott MA, Lipori PJ, Lewis SB
Author(s): Kaku Y, Yamashita K, Kokuzawa J, Hatsuda N, Andoh T
Author(s): Birski M, Walesa C, Gaca W, Paczkowski D, Birska J, et al.
Author(s): Bohman L, Winn H, LeRoux P