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ヨコサコ スグル
Yokosako Suguru
横佐古 卓 所属 医学部 医学科（附属足立医療センター） 職種 助教 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Appropriate treatment within 13 hours after onset may improve outcome in patients with high-grade aneurysmal subarachnoid hemorrhage. |
| 掲載誌名 | 正式名：Clinical neurology and neurosurgery 略 称：Clin Neurol Neurosurg ISSNコード：18726968/03038467 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 230,pp.107776 |
| 著者・共著者 | Ohbuchi Hidenori, Kasuya Hidetoshi, Hagiwara Shinji, Kanazawa Ryuzaburo, Yokosako Suguru, Arai Naoyuki, Takahashi Yuichi, Chernov Mikhail, Kubota Yuichi |
| 発行年月 | 2023/07 |
| 概要 | OBJECTIVE:This retrospective study evaluated whether earlier timing of appropriate treatment of high-grade aneurysmal subarachnoid hemorrhage (aSAH), defined as management of ruptured intracranial aneurysm (RIA) combined with required additional surgical measures for control of increased intracranial pressure (ICP), is associated with more favorable outcomes.METHODS:The study cohort comprised 253 patients with high-grade aSAH. Modified Rankin Scale score of 0-3 at 3-month follow-up after the ictus was considered as favorable outcome.RESULTS:Appropriate treatment of aSAH was completed in 205 patients (81 %), and included clipping or coiling of RIA without (64 cases) and with (141 cases) additional surgical measures for control of increased ICP (evacuation of intracranial hematoma, decompressive craniotomy, and/or cerebrospinal fluid drainage). Favorable outcome was noted significantly more often if appropriate treatment was completed within 13 h after aSAH than between 13 and 72 h (37 % vs. 17 %; adjusted P = 0.0475), which was confirmed by evaluation in the multivariate model along with other prognostic factors. Subgroup analysis revealed that completion of the appropriate treatment within 13 h was associated with more favorable outcome in those patients, who underwent management of RIA in combination with additional surgical measures for control of increased ICP (P = 0.0023), and in those, who felt into poor outcome predicting group (P = 0.0046).CONCLUSIONS:Appropriate treatment of high-grade aSAH with management of RIA in combination with required additional surgical measures for control of increased ICP, may be associated with more favorable outcomes if completed within 13 h after the ictus. |
| DOI | 10.1016/j.clineuro.2023.107776 |
| PMID | 37229951 |