Functional Outcome After Poor-Grade Subarachnoid Hemorrhage: A Single-Center Study and Systematic Literature Review

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dc.citation.issue3
dc.citation.volume25
dc.contributor.authorManoel, Airton Leonardo de Oliveira [UNIFESP]
dc.contributor.authorMansur, Ann
dc.contributor.authorSilva, Gisele Sampaio [UNIFESP]
dc.contributor.authorGermans, Menno R.
dc.contributor.authorJaja, Blessing N. R.
dc.contributor.authorKouzmina, Ekaterina
dc.contributor.authorMarotta, Thomas R.
dc.contributor.authorAbrahamson, Simon
dc.contributor.authorSchweizer, Tom A.
dc.contributor.authorSpears, Julian
dc.contributor.authorMacdonald, R. Loch
dc.coverageTotowa
dc.date.accessioned2020-07-31T12:47:10Z
dc.date.available2020-07-31T12:47:10Z
dc.date.issued2016
dc.description.abstractPoor-grade subarachnoid hemorrhage (SAH) (World Federation of Neurosurgical Societies grade 4 and 5) is associated with high mortality rates and unfavorable functional outcomes. We report a single-center cohort of poor-grade SAH patients, combined with a systematic review of studies reporting functional outcome in the poor-grade SAH population. Data on a cohort of poor-grade SAH patients treated between 2009 and 2013 were retrospectively collected and combined with a systematic review (from inception to November 2015en
dc.description.abstractPubMed, Embase). Two reviewers assessed the studies independently based on predefined inclusion criteria: consecutive poor-grade SAH, functional outcome measured at least 3 months after hemorrhage, and the report of patients who died before aneurysm treatment. The search yielded 329 publications, and 23 met our inclusion criteria with 2713 subjects enrolled from 1977 to 2014 in 10 countries (including 179 poor-grade patients from our cohort). Mortality rate was 60 % (1683 patients), of which 806 (29 %) died before and 877 (31 %) died after aneurysm treatment, respectively. Treatment was undertaken in 1775 patients (1775/2826-63 %): 1347 by surgical clipping (1347/1775-76 %) and 428 (428/1775-24 %) by endovascular methods. Outcome was favorable in 794 patients (28 %) and unfavorable in 1867 (66 %). When the studies were grouped into decades, favorable outcome increased from 13 % in the late 1970s to early 1980s to 35 % in the late 1980s to early 1990s, and remained unchanged thereafter. Although mortality remains high in poor-grade SAH patients, a favorable functional outcome can be achieved in approximately one-third of patients. The development of new diagnostic methods and implementation of therapeutic approaches were probably responsible for the decrease in mortality and improvement in the functional outcome from 1970 to the 1990s. The plateau in functional outcome seen thereafter might be explained by the treatment of sicker and older patients and by the lack of new therapeutic interventions specific for SAH.en
dc.description.affiliationUniv Toronto, St Michaels Hosp, Dept Med Imaging, Intervent Neuroradiol, 3-141 CC,30 Bond St, Toronto, ON M5B 1W8, Canada
dc.description.affiliationUniv Toronto, St Michaels Hosp, Trauma & Neurosurg Intens Care Unit, Dept Crit Care Med, Toronto, ON, Canada
dc.description.affiliationSt Michaels Hosp, Keenan Res Ctr Biomed Sci, Neurosci Res Program, Toronto, ON, Canada
dc.description.affiliationUniv Fed Sao Paulo, Neurol & Neurosurg Dept, Sao Paulo, Brazil
dc.description.affiliationRadboud Univ Nijmegen, Med Ctr, Dept Neurosurg, Nijmegen, Netherlands
dc.description.affiliationUniv Toronto, St Michaels Hosp, Dept Anesthesiol, Toronto, ON, Canada
dc.description.affiliationUniv Toronto, St Michaels Hosp, Dept Surg, Div Neurosurg, Toronto, ON, Canada
dc.description.affiliationUniv Toronto, Fac Med, Toronto, ON, Canada
dc.description.affiliationInst Israelita Pesquisa Albert Einstein, Neurol Program, Sao Paulo, Brazil
dc.description.affiliationUnifespNeurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
dc.description.provenanceMade available in DSpace on 2020-07-31T12:47:10Z (GMT). No. of bitstreams: 0 Previous issue date: 2016en
dc.description.sourceWeb of Science
dc.description.sponsorshipPhysicians Services Incorporated Foundation
dc.description.sponsorshipBrain Aneurysm Foundation
dc.description.sponsorshipCanadian Institutes for Health Research
dc.description.sponsorshipHeart and Stroke Foundation of Canada
dc.format.extent338-350
dc.identifierhttp://dx.doi.org/10.1007/s12028-016-0305-3
dc.identifier.citationNeurocritical Care. Totowa, v. 25, n. 3, p. 338-350, 2016.
dc.identifier.doi10.1007/s12028-016-0305-3
dc.identifier.issn1541-6933
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/56630
dc.identifier.wosWOS:000389984600002
dc.language.isoeng
dc.publisherHumana Press Inc
dc.relation.ispartofNeurocritical Care
dc.rightsAcesso restrito
dc.subjectSubarachnoid hemorrhageen
dc.subjectPrognosisen
dc.subjectMortalityen
dc.subjectSystematic reviewen
dc.titleFunctional Outcome After Poor-Grade Subarachnoid Hemorrhage: A Single-Center Study and Systematic Literature Reviewen
dc.typeArtigo
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