UNIGE document Scientific Article
previous document  unige:90803  next document
add to browser collection
Title

Subarachnoid haemorrhage WFNS grade V: is maximal treatment worthwhile?

Authors
Wostrack, Maria
Sandow, Nora
Vajkoczy, Peter
Kehl, Victoria
Harmening, Kathrin
show hidden authors show all authors [1 - 13]
Published in Acta Neurochirurgica. 2013, vol. 155, no. 4, p. 579-586
Abstract BACKGROUND: Aneurysmal subarachnoid haemorrhage (SAH) WFNS grade V is commonly known to be associated with high mortality and a very poor prognosis for survivors. Therefore, maximal invasive therapy is frequently delayed until any spontaneous improvement with or without an external ventricular drainage occurs. The aim of the study was to verify possible predictive factors and the probability of a favourable outcome in maximally treated patients. METHODS: One hundred and thirty-eight consecutive patients with WFNS grade V SAH were admitted between 03/2006 and 12/2010. Thirty-five patients died before aggressive therapy could proceed. One hundred and three patients received maximal treatment and were retrospectively evaluated. The outcome was assessed at discharge and in the follow-up with the Glasgow Outcome Scale. Univariate and multivariate linear regression models were performed to find predictors for an unfavourable outcome. RESULTS: Despite treatment, early mortality was 30 % (n = 31). At discharge, the rate of both vegetative and severely disabled patients was 27 % (n = 28). Favourable outcome at discharge was observed in 16 % (n = 16) of cases, whereas in the follow-up it rose to 26 % (n = 27). Multivariate full model regression identified intraventricular haematoma (IVH) and increasing age as independently predictive for poor outcome. CONCLUSIONS: Despite treatment, initial mortality and severe disability remain high. Nevertheless, a favourable outcome was achieved in 26 % of aggressively treated patients, rendering the withdrawal of maximal therapy for WFNS grade V SAH patients unacceptable today. In cases of old patients with IVH, the indication for aggressive therapy should be put in place more carefully due to a very poor prognosis
Keywords Subarachnoid haemorrhagePoor-graded SAHCerebral aneurysm
Identifiers
PMID: 23397308
Full text
Article (Published version) (208 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Groupe Schaller Karl Lothard (neurochirurgie) (851)
Citation
(ISO format)
WOSTRACK, Maria et al. Subarachnoid haemorrhage WFNS grade V: is maximal treatment worthwhile?. In: Acta Neurochirurgica, 2013, vol. 155, n° 4, p. 579-586. https://archive-ouverte.unige.ch/unige:90803

28 hits

0 download

Update

Deposited on : 2017-01-04

Export document
Format :
Citation style :