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Mortality among patients treated for aneurysmal subarachnoid hemorrhage in Eastern Denmark 2017-2019

Agnes T Stauning1, Frank Eriksson2, Goetz Benndorf3,4

  • 1Department of Neurosurgery, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Copenhagen, Denmark. atvings@hotmail.com.

Acta Neurochirurgica
|July 21, 2022
PubMed

Insights

This study found that 16.1% of patients died within 12 months of aneurysm treatment. Key risk factors for death include severe hemorrhage, infections, rebleeding, and specific patient conditions, highlighting areas for improved aneurysm occlusion strategies.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Subarachnoid hemorrhage (SAH) from ruptured aneurysms carries significant mortality.
  • Effective aneurysm occlusion is crucial for patient survival and preventing secondary complications.

Purpose of the Study:

  • To determine 30-day, 3-month, and 12-month cumulative mortality rates after aneurysm occlusion.
  • To identify the primary causes of death in these patients.
  • To investigate potential risk factors associated with mortality following aneurysm treatment.

Main Methods:

  • A cohort study included 317 patients treated for ruptured aneurysms (surgical clipping or endovascular) between 2017-2019.
  • Patients were followed for 12 months to collect data on vital status, causes of death, and comorbidities.
  • Logistic regression models were used to assess associations between risk factors and mortality.

Main Results:

  • Overall cumulative mortality was 10.7% at 30 days, 12.9% at 3 months, and 16.1% at 12 months.
  • The leading causes of death were severe primary hemorrhage (52.9%), infections (15.7%), and rebleeding (11.8%).
  • Higher WFNS and Fisher scores, preprocedural hydrocephalus, and preprocedural rebleeding were significant risk factors for death.

Conclusions:

  • Aneurysm occlusion is associated with considerable mortality, with preventable causes contributing to a portion of deaths.
  • Reducing time to treatment and improving occlusion techniques are essential for reducing mortality.
  • Addressing pre- and postprocedural rebleeding is critical for improving patient outcomes.
Abstract

Keywords:
Endovascular treatmentMortalitySurgical clippingWNFS scoreaSAH

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