Factors for Vasospasm-Induced Cerebral Infarct When Both Clipping and Coiling Are Equally Available

Fig. 1
Incidence of vasospasm-induced cerebral infarct stratified by aneurysm location. () number of cases, P value chi-square test
With regard to outcomes (Table 1), the incidence of independent survival (mRS 0–2) was similar between clipping and coiling at both 3 (62.6 vs. 67.3 %) and 12 (67.3 vs. 71.4 %) months after SAH. Multivariate logistic regression with poor outcome (1-year mRS 3–6) as a binary outcome demonstrated vasospasm-induced cerebral infarct to be a significant prognostic factor when patient age, gender, admission WFNS grade, Fisher CT group, aneurysm location, dome size, neck size, pretreatment aneurysm rerupture (in hospital, n = 41, 7.6 %), treatment modality, antiplatelet therapy (n = 129, 24.0 %), CSF drainage (with/without irrigation, n = 365, 68.0 %), vasospasm-induced cerebral infarct (n = 95, 17.7 %), shunt-dependent hydrocephalus (n = 101, 18.8 %), epilepsy (n = 26, 4.8 %), infection (sepsis, pneumonia, etc.; n = 48, 8.9 %), noninfectious cardiopulmonary complications (n = 35, 6.5 %), clipping-related complications (n = 84, 15.6 %), and coiling-related complications (n = 52, 9.7 %) were used in the analyses (Table 2).
Table 1
Modified Rankin Scale (mRS) at 3 and 12 months after subarachnoid hemorrhage
Variable
Clip (n = 273)
Coil (n = 264)
P valuea
mRS at 3 months
n = 270
n = 263
 
 0
86 (31.9)
131 (49.8)
<0.001
 1
39 (14.4)
24 (9.1)
ns
 2
44 (16.3)
22 (8.4)
<0.01
 3
19 (7.0)
11 (4.2)
ns
 4
37 (13.7)
28 (10.6)
ns
 5
22 (8.1)
21 (8.0)
ns
 6
23 (8.5)
26 (9.9)
ns
 0–1
125 (46.3)
155 (58.9)
<0.005
 0–2
169 (62.6)
177 (67.3)
ns
mRS at 12 months
n = 263
n = 255
 
 0
105 (39.9)
145 (56.9)
<0.001
 1
36 (13.7)
25 (9.8)
ns
 2
36 (13.7)
12 (4.7)
<0.001
 3
21 (8.0)
13 (5.1)
ns
 4
25 (9.5)
17 (6.7)
ns
 5
14 (5.3)
14 (5.5)
ns
 6
26 (9.9)
29 (11.4)
ns
 0–1
141 (53.6)
170 (66.7)
<0.005
 0–2
177 (67.3)
182 (71.4)
ns
Number of cases (%)
ns not significant
aChi-square test
Table 2
Significant variables in multivariate logistic regression with poor outcome (1-year modified Rankin Scale 3–6) as a binary outcome
Variables
Odds ratio

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Nov 8, 2016 | Posted by in NEUROLOGY | Comments Off on Factors for Vasospasm-Induced Cerebral Infarct When Both Clipping and Coiling Are Equally Available

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