Age-dependent characteristics of specialized scale parameters in subarahnoidal hemorrhage of non-traumatic etiology
Keywords:age factors, atraumatic subarachnoid hemorrhage, GOSE scale, chi-square
Subarachnoid hemorrhage (SAH) is a condition with significant fluctuations in the incidence rate worldwide.
The aim of the study: to evaluate the disease course according to the neurological scales in patients of various age groups with spontaneous SAH of non-traumatic origin.
Material and methods. 87 patients with subarachnoid hemorrhage were examined, of whom 38 (43.68 %) were diagnosed with isolated form, 14 (16.09 %) – with subarachnoid-parenchymal, 29 (33.33 %) – with subarachnoid-ventricular, 6 (6.90 %) – with subarachnoid-parenchymal ventricular hemorrhage, the total number of mixed hemorrhages was 56.32 %.
Results. According to the modified Fisher scale, the severe grade with the most massive hemorrhage was statistically significantly (P < 0.05) more common in patients over 60 years old (25.0 % and 20.0 % of patients, respectively), and the presence of grades I–II was mainly observed in people under 40 years old (42.11 % and 31.58 % of patients, respectively).
On hospital admission, grade I subarachnoid hemorrhage (mild) according to the World Federation of Neurosurgical Societies classification prevailed in patients under 40 years old and 40–60 years old; I–II grades were more often diagnosed in patients of 60 years old. According to the Нunt & Неss scale, 50 % of patients over 60 years old had clinically minimal neurological symptoms and I degree of severity. The moderate, II–III degrees of severity, were noted in patients of the middle-age category (40–60 years). A critical condition with profound disorder of consciousness and neurologic impairments was diagnosed in patients aged younger than 40 years.
Conclusions. According to the results of the GOSE (Glasgow Outcome Scale Extended) score, the cohort of patients over the age of 60 years had a poor and guarded prognosis, more than a third part of the patients in each age group had the most optimal prognosis for recovery. The minimum score by the Ogilvy scale and good percentage of favorable outcomes possibility after subarachnoid hemorrhage were typical for patients under 40 years old.
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