Clinical features and treatment outcomes in patients older than 80 years with aneurysmal subarachnoid hemorrhage in an aging community

Abstract

Background and Purpose: The number of elderly patients with aneurysmal subarachnoid hemorrhage (SAH) has been increasing because of the rapid aging of society and the increasing incidence rate of SAH with age. We often have difficulty to make decision to perform surgery and optimal treatment method for these patients because they have higher surgical risks and their functional prognosis is also poor. The aim of this study was to reveal the clinical features and treatment outcomes of these patients. Methods: We retrospectively analyzed 47 patients, ≥80 years, out of 162 consecutive patients with aneurysmal SAH between April 2009 and December 2015. Results: The average age was 85.0 years, and the proportion of women (89%) was greater than men. Severe cases with World Federation of Neurosurgical Societies (WFNS) grade IV and V on admission accounted for 70% of all cases. The aneurysms were located in the anterior circulation in 95%. Twenty-two patients were treated for ruptured aneurysms with either surgical clipping or endovascular coiling. Favorable outcomes were achieved in 6% and the rate of mortality was 43%. Favorable outcomes in patients received surgical intervention tended to be associated with ≤84 years of age and lower WFNS grade (I–II). Conclusion: Although the treatment outcome in elderly patients with aneurysmal SAH is poor, radical treatment should be considered if the WFNS grade is low, and they are in a good preoperative general condition and are relatively independent in their daily living activities.