J Neurointensive Care.  2020 Apr;3(1):20-25. 10.32587/jnic.2020.00241.

Prognostic Factors of Clinical Outcome after Aneurysmal Clipping in the Aged Patients with Unruptured Intracranial Aneurysms

• Son MW
• Park JW
• Park KJ
• Kang SH
• Jung YG
• Park JY
• Park DH

• KMID: 2555034
• DOI: http://doi.org/10.32587/jnic.2020.00241

Abstract

Objective
To determine prognostic factors of clinical outcome after surgical clipping in elderly patients 65 years old and over with unruptured intracranial aneurysms (UIAs).
Methods
A total of 50 patients with UIAs who underwent surgical clipping between January 2006 and December 2016 were included in this study. These patients were divided into two groups according to Glasgow Outcome Scale (GOS) scores: good outcome group (GOS of 5) and poor outcome group (GOS of 1 to 4). Aneurysmal characteristics and clinical outcomes of patients were retrospectively reviewed for both groups.
Results
Among 50 patients, 38 showed good outcome while 12 had poor outcome. A multivariate study revealed that wide aneurysms neck (OR: 3.467, P = 0.023), small width (OR: 0.511, P = 0.048), large aspect ratio (OR: 9.050, P = 0.007), diabetes mellitus (OR: 1.048, P = 0.023), and smoke (OR: 1.091, P = 0.05) were significantly associated with poor outcome after surgical clipping.
Conclusion
Wide neck, small width, large aspect ratio, diabetes mellitus, and smoking were found to be independent prognostic factors associated with poor outcome in elderly patients after surgical clipping of aneurysms. Therefore, these factors in elderly patients should be taken into consideration before make a decision on treatment of unruptured aneurysm surgery.

Keyword

Predisposing factors; Unruptured intracranial aneurysms; Clipping; Outcome; Old age