Relationship between timing of ruptured cerebral aneurysm treatment and clinical outcome: A retrospective study
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Abstract
Background: Ruptured cerebral aneurysm is a neurovascular disease that cause high morbidity and mortality. Patients with ruptured cerebral aneurysm should be performed aneurysm treatment as early as possible. However, the ideal timing of aneurysm treatment (surgical clipping or endovascular coiling) is unknown and timing of aneurysm treatment may effect to clinical outcomes
Objectives: The study aimed to compared the clinical outcome of patients between different timings of aneurysm treatment at Hatyai hospital.
Methodology: A retrospective study 220 patients with ruptured cerebral aneurysm who was performed aneurysm treatment at Hatyai hospital. The patients were divided in 2 groups: early aneurysm treatment within days and delay aneurysm treatment more than 72 hours. The clinical outcomes of patients were accessed after 6 months by using the modified Rankin scale and mortality rate. For endovascular coiling and surgical clipping patients were accessed separately. The statistical methods used included frequency, percentage, Independent t-test and the Chi-square test.
Results: Functional independence or favorable clinical outcome (mRS 0-2) at 6 months between patient early aneurysm treatment and delay aneurysm treatment was 84 (70.0%) persons and 61 (76.2%) persons. There was no statistical difference in clinical outcome between patient early aneurysm treatment and delay aneurysm treatment (p = 0.210).
Conclusions: There was no statistically significant association between clinical outcome and timing of ruptured cerebral aneurysm treatment. However, the aneurysm treatment should be performed as soon as possible to prevent re-ruptured and minimized length of stay.
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References
Bederson JB, Connolly ES Jr, Batjer HH, Dacey RG, Dion JE, Diringer MN, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke. 2009;40(3):994–1025.
Kassell NF, Torner JC. Aneurysmal rebleeding: a preliminary report from the Cooperative Aneurysm Study. Neurosurgery. 1983;13(5):479–81.
Phillips TJ, Dowling RJ, Yan B, Laidlaw JD, Mitchell PJ. Does treatment of ruptured intracranial aneurysms within 24 hours improve clinical outcome? Stroke. 2011;42(7):1936–45.
Haley EC Jr, Kassell NF, Torner JC. The International Cooperative Study on the Timing of Aneurysm Surgery. The North American experience. Stroke. 1992;23(2):205–14.
Dorhout Mees SM, Molyneux AJ, Kerr RS, Algra A, Rinkel GJ. Timing of aneurysm treatment after subarachnoid hemorrhage: relationship with delayed cerebral ischemia and poor outcome. Stroke. 2012;43(8):2126–9.
Lawson MF, Chi YY, Velat GJ, Mocco JD, Hoh BL. Timing of aneurysm surgery: the International Cooperative Study revisited in the era of endovascular coiling. J Neurointerv Surg. 2010;2(2):131–4.
Nieuwkamp DJ, de Gans K, Algra A, Albrecht KW, Boomstra S, Brouwers PJ, et al. Timing of aneurysm surgery in subarachnoid haemorrhage—an observational study in The Netherlands. Acta Neurochir (Wien). 2005;147(8):815–21.
Whitfield PC, Kirkpatrick PJ. Timing of surgery for aneurysmal subarachnoid haemorrhage. Cochrane Database Syst Rev. 2001;(2):CD001697.
de Gans K, Nieuwkamp DJ, Rinkel GJ, Algra A. Timing of aneurysm surgery in subarachnoid hemorrhage: a systematic review of the literature. Neurosurgery. 2002;50(2):336–40; discussion 340–2.
Yao Z, Hu X, Ma L, You C, He M. Timing of surgery for aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. Int J Surg. 2017;48:266–74.
