Effect of Age on Outcomes of Treatment of Unruptured Cerebral Aneurysms A Study of the National Inpatient Sample 2001-2008
Effect of Age on Outcomes of Treatment of Unruptured Cerebral Aneurysms A Study of the National Inpatient Sample 2001-2008
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DOI：
10.1161/strokeaha.110.607986
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发表时间：
2011-05-01
期刊：
影响因子：
8.3
通讯作者：
Cloft, Harry J.
中科院分区：
文献类型：
--
作者：
Brinjikji, Waleed;Rabinstein, Alejandro A.;Cloft, Harry J.
背景和目的-年龄可能对手术夹闭和血管内弹簧圈治疗未破裂脑动脉瘤患者的结局产生不同的影响。我们评估了一个大型的管理数据库，以确定年龄对未破裂脑动脉瘤治疗患者的结局的影响。方法使用国家住院患者样本，我们评估了2001年至2008年期间在美国接受夹闭或弹簧圈栓塞未破裂脑动脉瘤患者的发病率（出院到长期设施）和死亡率。结果评估与四个年龄层相关：小于50岁; 50 - 64岁; 65 - 79岁;和80岁或以上的患者。结果：与接受夹闭术的患者相比，小于50岁接受弹簧圈栓塞术的患者的发病率显著降低（3.5%对8.1%; P < 0.0001），但死亡率无差异（0.6%对0.6%; P = 0.72）。与接受夹闭术的患者相比，接受弹簧圈栓塞术的50 - 64岁患者的发病率（4.0% vs 13.7%; P < 0.0001）和死亡率（0.5% vs 1.1%; P < 0.0001）显著降低。与接受夹闭术的患者相比，65 - 79岁的弹簧圈栓塞患者的发病率（6.9% vs 26.8%; P < 0.0001）和死亡率（0.8% vs 2.0%; P < 0.0001）较低。接受弹簧圈栓塞术的80岁或以上患者的发病率也较低（9.8%对33.5%; P < 0.0001）和死亡率（2.4%对21.4%; P < 0.0001）。结论：血管内弹簧圈栓塞治疗的患者发病率和死亡率明显低于手术夹闭治疗的患者，这些差异随着年龄的增长而变得更加明显。（中风。2011;42：1320-1324.）
Background and Purpose-Age might differentially affect outcomes in patients treated for unruptured cerebral aneurysms with surgical clipping versus endovascular coil therapy. We evaluated a large administrative database to determine the effect of age on outcomes in patients treated for unruptured cerebral aneurysm.Methods-Using the National Inpatient Sample, we evaluated morbidity (discharge to long-term facility) and mortality of patients undergoing clipping or coiling of unruptured cerebral aneurysms in the United States between 2001 and 2008. Outcomes were evaluated in relation to four age strata: younger than 50 years; 50 to 64 years; 65 to 79 years; and patients 80 years or older.Results-Patients younger than 50 years old undergoing coiling had significantly lower morbidity rates when compared to patients who underwent clipping (3.5% versus 8.1%; P < 0.0001), but no difference in mortality (0.6% versus 0.6%; P = 0.72). Patients between 50 and 64 years old undergoing coiling had significantly decreased morbidity (4.0% versus 13.7%; P < 0.0001) and mortality (0.5% versus 1.1%; P < 0.0001) when compared to patients who underwent clipping. Coiled patients 65 to 79 years old had lower morbidity (6.9% versus 26.8%; P < 0.0001) and mortality (0.8% versus 2.0%; P < 0.0001) compared to patients who underwent clipping. Patients aged 80 years or older undergoing coiling also had lower morbidity (9.8% versus 33.5%; P < 0.0001) and mortality (2.4% versus 21.4%; P < 0.0001) when compared to patients who have undergone clipping.Conclusions-Patients treated with endovascular coiling have significantly less morbidity and mortality than those treated with surgical clipping, and these differences become more pronounced with age. (Stroke. 2011;42:1320-1324.)