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Long-term excess mortality in pediatric patients with cerebral aneurysms

Päivi Koroknay-Pál1, Aki Laakso, Hanna Lehto

  • 1Department of Neurosurgery, Helsinki University Central Hospital, Finland. paivi.koroknay-pal@hus.fi

Stroke
|June 14, 2012
PubMed

Insights

Pediatric cerebral aneurysm patients face long-term excess mortality, particularly boys, even after treatment. Most late deaths are linked to the aneurysm itself, highlighting the need for ongoing monitoring.

Area of Science:

  • Pediatric Neurosurgery
  • Cerebrovascular Diseases
  • Epidemiology

Background:

  • Long-term outcomes for pediatric cerebral aneurysm patients are not well understood.
  • Cerebral aneurysms in children are rare but can have severe consequences.

Purpose of the Study:

  • To assess the long-term excess mortality in pediatric patients diagnosed with cerebral aneurysms.
  • To compare the survival rates of pediatric aneurysm patients with the general Finnish population.

Main Methods:

  • A cohort of 102 pediatric cerebral aneurysm patients treated between 1937 and 2009 was followed until 2010.
  • Relative survival ratios were calculated to measure excess mortality against age-, sex-, and time-matched controls.

Main Results:

  • Overall excess mortality was observed, with cumulative relative survival ratios of 0.90 at 20 years and 0.81 at 40 years post-diagnosis for subarachnoid hemorrhage survivors.
  • Aneurysm-related deaths accounted for 76% of all deaths, including rebleeding and sequelae of subarachnoid hemorrhage.
  • Excess mortality was significantly higher in boys, and no long-term excess mortality was found in patients with unruptured aneurysms.

Conclusions:

  • Pediatric cerebral aneurysm patients experience long-term excess mortality, persisting for decades after treatment.
  • Aneurysm-related complications are the primary cause of late mortality in this cohort.
  • Boys with pediatric cerebral aneurysms face a particularly high risk of long-term excess mortality.
Abstract

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