Title :

A randomized controlled study assessing outcome, cognition, autonomy and quality of life in over 70-year-old patients after aneurysmal subarachnoid hemorrhage

Author(s) :

Proust, F. [Auteur]
Bracard, Serge [Auteur]
Lejeune, Jean-Paul [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Thines, Laurent [Auteur]
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Penchet, G. [Auteur]
Berge, Jerome [Auteur]
Morandi, X. [Auteur]
Gauvrit, J-Y [Auteur]
Mourier, K. [Auteur]
Ricolfi, Frederic [Auteur]
Lonjon, M. [Auteur]
Sedat, Jacques [Auteur]
Bataille, B. [Auteur]
Droineau, J. [Auteur]
Civit, T. [Auteur]
Magro, E. [Auteur]
Pelissou-Guyotat, I. [Auteur]
Cebula, H. [Auteur]
Lallouche, K. [Auteur]
David, Pierre-Maxime [Auteur]
Emery, E. [Auteur]
Courtheoux, P. [Auteur]
Vignes, J-R [Auteur]
Benichou, J. [Auteur]
Aghakani, N. [Auteur]
Roche, P-H [Auteur]
Gay, E. [Auteur]
Bessou, P. [Auteur]
Guabrillargues, J. [Auteur]
Irthum, B. [Auteur]

Journal title :

Neuro-Chirurgie

Abbreviated title :

Neurochirurgie

Publication date :

2018-10-16

ISSN :

1773-0619

English keyword(s) :

Elderly
Randomized controlled study
Intracranial aneurysm
Subarachnoid hemorrhage

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Current aging of the population with good physiological status and the increasing incidence of subarachnoid hemorrhage (SAH) in elderly patients has enhanced the benefit of treatment in terms of independence ...
Show more >BACKGROUND: Current aging of the population with good physiological status and the increasing incidence of subarachnoid hemorrhage (SAH) in elderly patients has enhanced the benefit of treatment in terms of independence and long-term quality of life (QoL). METHODS: From November 1, 2008 to October 30, 2012, 351 patients aged 70 years or older with aneurysmal SAH underwent adapted treatment: endovascular coiling (EV) for 228 (65%) patients, microsurgical clipping (MS) for 75 (29.3%) or conservative treatment for 48 (13.7%). Forty-one of these were randomized to EV (n=20) or to MS (n=21). The objectives were to determine the proportion of patients with modified Rankin Scale score≤2 (independence) at 1 year, and, secondarily, to compare cognitive function on the Mini-Mental State Examination (MMSE), autonomy on the Activities of Daily Living Index (ADLI) and Instrumental Activities of Daily Living scale (IADL), and QoL, in the prospective and randomized arms, at 1 year. RESULTS: At 1 year, with 1 loss to follow-up in the EV arm, 11 patients (55%) were independent after EV occlusion and 8 (38.1%) after MS exclusion, without significant difference (P=0.29). Mortality was higher after MS during the first 2 postoperative months, and thereafter the difference between MS and EV ceased to be significant. Cognitive function and autonomy scores were similar in both arms. CONCLUSIONS: In elderly patients treated for aneurysmal SAH, approximately 50% were independent at 1 year, with conserved cognition and autonomy. EV and MS are valid procedures in this population, with similar results at 1 year in terms of independence, cognition, autonomy, and QoL.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Submission date :

2019-11-27T14:32:02Z