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dc.contributor.authorTeo, Marioen
dc.contributor.authorGuilfoyle, Mathew Ren
dc.contributor.authorTurner, Caroleen
dc.contributor.authorKirkpatrick, Peter Jen
dc.contributor.authorSTASH Collaborators,en
dc.date.accessioned2017-08-02T15:58:11Z
dc.date.available2017-08-02T15:58:11Z
dc.date.issued2017-09en
dc.identifier.issn1878-8750
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/265866
dc.description.abstractINTRODUCTION: The management of aneurysmal SAH has changed dramatically in the last few decades with the publication of a few major studies including The International Cooperative Study on the Timing of Aneurysm Surgery Study, International Subarachnoid Aneurysm Trial (ISAT). The aim of this study is to analyse the outcome of patients with aSAH based on a contemporary series, identify the risk factors for poor outcome, and focusing on patients with good grades aSAH (to match the ISAT cohort). METHOD: Baseline demographic and outcome data (mRS) was available on the 803 patients recruited from the STASH (Simvastatin in aneurysmal subarachnoid haemorrhage) trial for post hoc analysis, using chi square test or two-sample t-test. Logistic regression analysis was performed to assess the risk factors for poor outcome at 6 months. Propensity matched analysis comparing coiling and clipping, and subgroup analysis of good grades patients (WFNS I-II) were also performed. RESULT: Logistic regression analysis showed that the treatment modality (i.e coiling or clipping) was not associated with poor outcome at 6 months (p=0.839). The risk factors associated with poor outcome at 6 months were poor admission WFNS grade (p<0.0001), Fisher grade on initial CT scan (p=0.013), and the development of delayed cerebral ischaemia (DCI) (p<0.0001). Subgroup analysis for good grades patients only showed 82% of patients post coiling, and 78% of patients post clipping were classed as good outcome at 6 months (p=0.181). CONCLUSION: In the current era of aSAH management, apart from patients' admission status, SAH blood load and the development of DCI, treatment modality with either coiling or clipping was not associated with poor outcome difference at 6 months.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.language.isoenen
dc.publisherElsevier
dc.subjectSTASH Collaboratorsen
dc.subjectHumansen
dc.subjectIntracranial Aneurysmen
dc.subjectSubarachnoid Hemorrhageen
dc.subjectSimvastatinen
dc.subjectAnticholesteremic Agentsen
dc.subjectAngiography, Digital Subtractionen
dc.subjectTreatment Outcomeen
dc.subjectRisk Factorsen
dc.subjectRegression Analysisen
dc.subjectTomography Scanners, X-Ray Computeden
dc.subjectAge Factorsen
dc.subjectInternational Cooperationen
dc.subjectAdolescenten
dc.subjectAdulten
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectOutcome Assessment (Health Care)en
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.subjectEndovascular Proceduresen
dc.titleWhat Factors Determine Treatment Outcome in Aneurysmal Subarachnoid Hemorrhage in the Modern Era? A Post Hoc STASH Analysis.en
dc.typeArticle
prism.endingPage281
prism.publicationDate2017en
prism.publicationNameWorld neurosurgeryen
prism.startingPage270
prism.volume105en
dc.identifier.doi10.17863/CAM.12251
dcterms.dateAccepted2017-05-02en
rioxxterms.versionofrecord10.1016/j.wneu.2017.05.005en
rioxxterms.versionAMen
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
rioxxterms.licenseref.startdate2017-09en
dc.contributor.orcidTurner, Carole [0000-0002-8297-4890]
dc.identifier.eissn1878-8769
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2018-05-11


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