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Early ambulation produces favorable outcome and non-demential state in aneurysmal subarachnoid hemorrhage patients over 70 years of age.
MedLine Citation:
PMID:  23314032     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: We analyzed consecutive subarachnoid hemorrhage (SAH) cases in patients over 70 years of age who underwent aneurysm surgery. We report the influence of early ambulation on outcome in advanced-age SAH. METHODS: From 2005 through 2010, seventy-one aneurysmal SAH cases whose Hunt-Hess (HH) grades ranged from 1 to 3 were included. All cases underwent clip ligation or coil embolization. Male to female ratio was 8/63; median age was 76 years (range: 70 ∼ 87). We routinely have patients become ambulatory the day after surgery. The ambulation date was used to determine four groupings: 0 ∼ 5 days, 6 ∼ 10 days, 11 ∼ 15 days and 16 days∼. We analyzed the relationship between ambulation date and the Glasgow Outcome Scale (GOS) or dementia at 30 days after the SAH. Favorable outcome was defined as good recovery and moderate disability according to the GOS. Dementia was screened using the revised-Hasegawa dementia scale. The chi-square test was used and a p-value below 0.05 was considered statistically significant. RESULTS: Mean days to ambulation was 10.7±9.3 (SD) days. Forty-eight cases (66%) achieved favorable outcome and 27 cases (38%) reached a non-demential state. Early ambulation positively correlated with favorable GOS and post-operative non-demential state. CONCLUSIONS: Elderly SAH patients with good HH grades should have a clip ligation or endovascular coiling. Early ambulation produces favorable outcome and a non-demential state in elderly SAH patients.
Authors:
Norihito Shimamura; Naoya Matsuda; Junko Satou; Takahiro Nakano; Hiroki Ohkuma
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  World neurosurgery     Volume:  -     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
Affiliation:
Department of Neurosurgery, Hirosaki University School of Medicine. Electronic address: shimab@cc.hirosaki-u.ac.jp.
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