Sex differences in patients with and without high-risk factors associated with aneurysmal subarachnoid hemorrhage
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature..
BACKGROUND: Controversy remains regarding the appropriate screening for intracranial aneurysms or for the treatment of aneurysmal subarachnoid hemorrhage (aSAH) for patients without known high-risk factors for rupture. This study aimed to assess how sex affects both aSAH presentation and outcomes for aSAH treatment.
METHOD: A retrospective cohort study was conducted of all patients treated at a single institution for an aSAH during a 12-year period (August 1, 2007-July 31, 2019). An analysis of women with and without high-risk factors was performed, including a propensity adjustment for a poor neurologic outcome (modified Rankin Scale [mRS] score > 2) at follow-up.
RESULTS: Data from 1014 patients were analyzed (69% [n = 703] women). Women were significantly older than men (mean ± SD, 56.6 ± 14.1 years vs 53.4 ± 14.2 years, p < 0.001). A significantly lower percentage of women than men had a history of tobacco use (36.6% [n = 257] vs 46% [n = 143], p = 0.005). A significantly higher percentage of women than men had no high-risk factors for aSAH (10% [n = 70] vs 5% [n = 16], p = 0.01). The percentage of women with an mRS score > 2 at the last follow-up was significantly lower among those without high-risk factors (34%, 24/70) versus those with high-risk factors (53%, 334/633) (p = 0.004). Subsequent propensity-adjusted analysis (adjusted for age, Hunt and Hess grade, and Fisher grade) found no statistically significant difference in the odds of a poor outcome for women with or without high-risk factors for aSAH (OR = 0.7, 95% CI = 0.4-1.2, p = 0.18).
CONCLUSIONS: A higher percentage of women versus men with aSAH had no known high-risk factors for rupture, supporting more aggressive screening and management of women with unruptured aneurysms.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:166 |
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| Enthalten in: |
Acta neurochirurgica - 166(2024), 1 vom: 08. März, Seite 125 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Catapano, Joshua S [VerfasserIn] |
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| Links: |
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| Themen: |
Aneurysmal subarachnoid |
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| Anmerkungen: |
Date Completed 11.03.2024 Date Revised 11.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00701-024-06021-1 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369468171 |
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| 245 | 1 | 0 | |a Sex differences in patients with and without high-risk factors associated with aneurysmal subarachnoid hemorrhage |
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| 520 | |a © 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature. | ||
| 520 | |a BACKGROUND: Controversy remains regarding the appropriate screening for intracranial aneurysms or for the treatment of aneurysmal subarachnoid hemorrhage (aSAH) for patients without known high-risk factors for rupture. This study aimed to assess how sex affects both aSAH presentation and outcomes for aSAH treatment | ||
| 520 | |a METHOD: A retrospective cohort study was conducted of all patients treated at a single institution for an aSAH during a 12-year period (August 1, 2007-July 31, 2019). An analysis of women with and without high-risk factors was performed, including a propensity adjustment for a poor neurologic outcome (modified Rankin Scale [mRS] score > 2) at follow-up | ||
| 520 | |a RESULTS: Data from 1014 patients were analyzed (69% [n = 703] women). Women were significantly older than men (mean ± SD, 56.6 ± 14.1 years vs 53.4 ± 14.2 years, p < 0.001). A significantly lower percentage of women than men had a history of tobacco use (36.6% [n = 257] vs 46% [n = 143], p = 0.005). A significantly higher percentage of women than men had no high-risk factors for aSAH (10% [n = 70] vs 5% [n = 16], p = 0.01). The percentage of women with an mRS score > 2 at the last follow-up was significantly lower among those without high-risk factors (34%, 24/70) versus those with high-risk factors (53%, 334/633) (p = 0.004). Subsequent propensity-adjusted analysis (adjusted for age, Hunt and Hess grade, and Fisher grade) found no statistically significant difference in the odds of a poor outcome for women with or without high-risk factors for aSAH (OR = 0.7, 95% CI = 0.4-1.2, p = 0.18) | ||
| 520 | |a CONCLUSIONS: A higher percentage of women versus men with aSAH had no known high-risk factors for rupture, supporting more aggressive screening and management of women with unruptured aneurysms | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Aneurysmal subarachnoid | |
| 650 | 4 | |a Females | |
| 650 | 4 | |a Ruptured aneurysm | |
| 650 | 4 | |a Sex | |
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| 700 | 1 | |a Koester, Stefan W |e verfasserin |4 aut | |
| 700 | 1 | |a Srinivasan, Visish M |e verfasserin |4 aut | |
| 700 | 1 | |a Cole, Tyler S |e verfasserin |4 aut | |
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