Adverse events associated with microsurgial treatment for ruptured intracerebral aneurysms : A prospective nationwide study on subarachnoid haemorrhage in Sweden
(2023) In Journal of Neurology, Neurosurgery and Psychiatry 94(7). p.575-580- Abstract
Background Adverse events (AEs) or complications may arise secondary to the treatment of aneurysmal subarachnoid haemorrhage (SAH). The aim of this study was to identify AEs associated with microsurgical occlusion of ruptured aneurysms, as well as to analyse their risk factors and impact on functional outcome. Methods Patients with aneurysmal SAH admitted to the neurosurgical centres in Sweden were prospectively registered during a 3.5-year period (2014-2018). AEs were categorised as intraoperative or postoperative. A range of variables from patient history and SAH characteristics were explored as potential risk factors for an AE. Functional outcome was assessed approximately 1 year after the bleeding using the extended Glasgow Outcome... (More)
Background Adverse events (AEs) or complications may arise secondary to the treatment of aneurysmal subarachnoid haemorrhage (SAH). The aim of this study was to identify AEs associated with microsurgical occlusion of ruptured aneurysms, as well as to analyse their risk factors and impact on functional outcome. Methods Patients with aneurysmal SAH admitted to the neurosurgical centres in Sweden were prospectively registered during a 3.5-year period (2014-2018). AEs were categorised as intraoperative or postoperative. A range of variables from patient history and SAH characteristics were explored as potential risk factors for an AE. Functional outcome was assessed approximately 1 year after the bleeding using the extended Glasgow Outcome Scale. Results In total, 1037 patients were treated for ruptured aneurysms, of which, 322 patients were treated with microsurgery. There were 105 surgical AEs in 97 patients (30%); 94 were intraoperative AEs in 79 patients (25%). Aneurysm rerupture occurred in 43 patients (13%), temporary occlusion of the parent artery >5 min in 26 patients (8%) and adjacent vessel injury in 25 patients (8%). High Fisher grade and brain oedema on CT were related to increased risk of AEs. At follow-up, 38% of patients had unfavourable outcome. Patients suffering AEs were more likely to have unfavourable outcome (OR 2.3, 95% CI 1.10 to 4.69). Conclusion Intraoperative AEs occurred in 25% of patients treated with microsurgery for ruptured intracerebral aneurysm in this nationwide survey. Although most operated patients had favourable outcome, AEs were associated with increased risk of unfavourable outcome.
(Less)
- author
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- CEREBROVASCULAR DISEASE, NEUROSURGERY, SUBARACHNOID HAEMORRHAGE
- in
- Journal of Neurology, Neurosurgery and Psychiatry
- volume
- 94
- issue
- 7
- pages
- 6 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:36931713
- scopus:85152203562
- ISSN
- 0022-3050
- DOI
- 10.1136/jnnp-2022-330982
- language
- English
- LU publication?
- yes
- id
- f28101c5-655a-451a-a298-3261d65338ee
- date added to LUP
- 2023-07-19 12:07:45
- date last changed
- 2024-04-19 23:41:53
@article{f28101c5-655a-451a-a298-3261d65338ee,
abstract = {{<p>Background Adverse events (AEs) or complications may arise secondary to the treatment of aneurysmal subarachnoid haemorrhage (SAH). The aim of this study was to identify AEs associated with microsurgical occlusion of ruptured aneurysms, as well as to analyse their risk factors and impact on functional outcome. Methods Patients with aneurysmal SAH admitted to the neurosurgical centres in Sweden were prospectively registered during a 3.5-year period (2014-2018). AEs were categorised as intraoperative or postoperative. A range of variables from patient history and SAH characteristics were explored as potential risk factors for an AE. Functional outcome was assessed approximately 1 year after the bleeding using the extended Glasgow Outcome Scale. Results In total, 1037 patients were treated for ruptured aneurysms, of which, 322 patients were treated with microsurgery. There were 105 surgical AEs in 97 patients (30%); 94 were intraoperative AEs in 79 patients (25%). Aneurysm rerupture occurred in 43 patients (13%), temporary occlusion of the parent artery >5 min in 26 patients (8%) and adjacent vessel injury in 25 patients (8%). High Fisher grade and brain oedema on CT were related to increased risk of AEs. At follow-up, 38% of patients had unfavourable outcome. Patients suffering AEs were more likely to have unfavourable outcome (OR 2.3, 95% CI 1.10 to 4.69). Conclusion Intraoperative AEs occurred in 25% of patients treated with microsurgery for ruptured intracerebral aneurysm in this nationwide survey. Although most operated patients had favourable outcome, AEs were associated with increased risk of unfavourable outcome.</p>}},
author = {{Baldvinsdóttir, Bryndís and Kronvall, Erik and Ronne-Engström, Elisabeth and Enblad, Per and Lindvall, Peter and Aineskog, Helena and Friðriksson, Steen and Klurfan, Paula and Svensson, Mikael and Alpkvist, Peter and Hillman, Jan and Eneling, Johanna and Nilsson, Ola G.}},
issn = {{0022-3050}},
keywords = {{CEREBROVASCULAR DISEASE; NEUROSURGERY; SUBARACHNOID HAEMORRHAGE}},
language = {{eng}},
number = {{7}},
pages = {{575--580}},
publisher = {{BMJ Publishing Group}},
series = {{Journal of Neurology, Neurosurgery and Psychiatry}},
title = {{Adverse events associated with microsurgial treatment for ruptured intracerebral aneurysms : A prospective nationwide study on subarachnoid haemorrhage in Sweden}},
url = {{http://dx.doi.org/10.1136/jnnp-2022-330982}},
doi = {{10.1136/jnnp-2022-330982}},
volume = {{94}},
year = {{2023}},
}