Cognitive Impairments and Risk Factors After Ruptured Anterior Communicating Artery Aneurysm Treatment in Low-Grade Patients Without Severe Complications: A Multicenter Retrospective Study.
Cognitive Impairments and Risk Factors After Ruptured Anterior Communicating Artery Aneurysm Treatment in Low-Grade Patients Without Severe Complications: A Multicenter Retrospective Study.
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无严重并发症的低级别患者前交通动脉瘤破裂治疗后的认知障碍和危险因素：一项多中心回顾性研究
DOI：
10.3389/fneur.2021.613785
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发表时间：
2021
影响因子：
3.4
通讯作者：
Liu A
中科院分区：
文献类型：
--
作者：
Ma N;Feng X;Wu Z;Wang D;Liu A
背景：认知功能障碍是影响轻度蛛网膜下腔出血患者生活质量的主要因素。目的：我们探讨了在无严重并发症的低级别（Hunt-Hess分级1-3）患者中治疗破裂的前交通动脉（AComA）动脉瘤后的认知障碍和风险因素。研究方法：对2015年1月至2017年12月在中国三家学术机构接受显微外科夹闭或血管内栓塞治疗破裂AComA动脉瘤的126例Hunt-Hess分级为1-3级的患者进行了评估，采用改良的认知状态电话访谈（TICS-m）、改良的兰金量表（mRS）、以及显微外科夹闭或血管内弹簧圈栓塞术后2年或更长时间的工具性日常生活活动（IADL）量表。多元cox回归分析用于识别与认知障碍独立相关的变量。结果如下：在126例患者中，115例（91.3%）临床结局良好（mRS评分0-2），109例（86.5%）生活质量极佳（IADL评分8）。28例（22.2%）患者表现出认知障碍（TICS-m≤27）。多因素考克斯回归分析显示，女性患者和SAH发作时意识丧失持续时间较长是认知功能障碍的独立相关因素。手术夹闭和弹簧圈栓塞后治疗的患者在末次随访时的认知结局无显著差异。结论：大约五分之一的患者在治疗破裂的AComA动脉瘤后表现出认知障碍。女性患者和SAH发作时意识丧失持续时间较长的患者可能存在认知障碍的风险。
Background: Cognitive impairment is the main factor affecting quality of life in patients with low-grade aneurysmal subarachnoid hemorrhage. Objective: We explored cognitive impairments and risk factors after treatment for ruptured anterior communicating artery (AComA) aneurysms in low-grade (Hunt-Hess grade of 1–3) patients without severe complications. Methods: One-hundred-twenty-six patients with a Hunt-Hess grade of 1–3 who underwent microsurgical clipping or endovascular embolization for ruptured AComA aneurysm treatment at three academic institutions in China from January 2015 to December 2017 were assessed with the modified Telephone Interview for Cognitive Status (TICS-m), the modified Rankin Scale (mRS), and the instrumental activities of daily living (IADL) scale 2 or more years after microsurgical clipping or endovascular coiling. Multiple cox-regression analysis was used to identify variables independently associated with cognitive impairment. Results: Of the total of 126 patients, 115 (91.3%) achieved good clinical outcomes (mRS score 0–2) and 109 (86.5%) had excellent quality of life (IADL score 8). Twenty-eight (22.2%) patients showed cognitive impairments (TICS-m≤27). The multivariate COX regression analysis showed that the female patients and longer duration of loss of consciousness at onset of subarachnoid hemorrhage (SAH) were independently associated with cognitive impairment. Cognitive outcome at the latest follow-up was not significantly different between patients treated after surgical clipping and coiling. Conclusion: About one in five patients showed cognitive impairments after treatment for ruptured AComA aneurysms. Patients who are of the female sex, and who have a longer duration of a loss of consciousness at the onset of SAH may be at risk of cognitive impairment.
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影响因子：
11.2
作者：
Jacova, Claudia;Pearce, Lesly A.;Costello, Raymond;McClure, Leslie A.;Holliday, Stephen L.;Hart, Robert G.;Benavente, Oscar R.
通讯作者：
Benavente, Oscar R.
DOI：
10.1017/cjn.2018.16
发表时间：
2018-07
期刊：
The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques
影响因子：
--
作者：
Nassiri F;Workewych AM;Badhiwala JH;Cusimano MD
通讯作者：
Cusimano MD
影响因子：
168.9
作者：
Molyneux, AJ;Kerr, RSC;Sandercock, P
通讯作者：
Sandercock, P
影响因子：
4.8
作者：
Buchanan, KM;Elias, LJ;Goplen, GB
通讯作者：
Goplen, GB
影响因子：
8.3
作者：
de Bresser, Jeroen;Vincken, Koen L.;Biessels, Geert Jan
通讯作者：
Biessels, Geert Jan