高齢化が進む三重県伊勢志摩地区におけるくも膜下出血の解析─10年間 448例の解析─

抄録

The number of elderly patients presenting with aneurysmal subarachnoid hemorrhage (SAH) is increasing. Population aging in the region is higher than in the urban areas. Hence, regional clinical data can be indicative of the future impact of increasing population aging in the urban areas. We retrospectively analyzed 448 patients with subarachnoid hemorrhage, treated at the Ise Red Cross Hospital between April 2004 and March 2014. The average age was 64.9 years (age range 23-98 yr.). Females predominated men (M:F = 145:303). Among men, the age distribution was 64 years or younger (66%), 65-74 years (23%), 75-84 years (10%), and 85 years or older (1%). Among females, the age distribution was 64 years or younger (39%), 65-74 years (24%), 75-84 years (24%), and 85 years or over (12%). We analyzed the Hunt and Hess grade, the location of aneurysms, treatments, cerebral vasospasms, shunt operations, and the modified Rankin Scale.
Most of the elderly patients presented with poor-grade SAH, and were managed conservatively. Majority of the treated patients were aged over 75 years, and had a modified Rankin Scale (mRS) score of 4 and 5. The patients in the mRS 4 group were categorized as either paralysis-type, or a decline-in-muscle-power-type. In the elderly patients group, we had more decline in muscle power-type patients than paralysis-type patients. Among the patients who underwent a shunt operation, 27% were from the elderly patient group, while 8% of the patients were aged 64 years or under.
Favorable outcomes in elderly patients can be obtained by good postoperative care to maintain patient amenity.