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. 2020 Nov 30;6(1):37.
doi: 10.1186/s41016-020-00216-y.

Evaluating the safety of early surgery for ruptured intracranial aneurysms in patients with long-term aspirin use: a propensity score matching study

Maogui Li  1   2   3   4 , Shuzhe Yang  1   2   3   4 , Qingyuan Liu  1   2   3   4 , Rui Guo  1   2   3   4 , Jun Wu  1   2   3   4 , Yong Cao  1   2   3   4 , Shuo Wang  5   6   7   8
Affiliations

Evaluating the safety of early surgery for ruptured intracranial aneurysms in patients with long-term aspirin use: a propensity score matching study

Maogui Li et al. Chin Neurosurg J. .

Abstract

Background: Early microsurgical clipping is recommended for ruptured intracranial aneurysms to prevent rebleeding. However, dilemma frequently occurs when managing patients with current acetylsalicylic acid (aspirin) use. This study aimed to examine whether aspirin use was associated with worse outcomes after early surgery for aneurysmal subarachnoid hemorrhage (aSAH).

Methods: We retrieved a consecutive series of 215 patients undergoing early microsurgical clipping within 72 h after aneurysmal rupture from 2012 to 2018 in the neurosurgery department of Beijing Tiantan Hospital. The medical records of each case were reviewed. Twenty-one patients had a history of long-term aspirin use before the onset of aSAH, and 194 patients did not. To reduce confounding bias, propensity score matching (PSM) was performed to balance some characteristics of the two groups. The intraoperative blood loss, postoperative hemorrhagic events, postoperative hospital stay, and functional outcome at discharge were compared between aspirin and non-aspirin group.

Results: We matched all the 21 patients in aspirin group with 42 patients in non-aspirin group (1:2). Potential confounding factors were corrected between the two groups by PSM. No hospital mortality occurred after surgery. No significant differences were found in intraoperative blood loss (P = 0.540), postoperative hemorrhagic events (P > 0.999), postoperative hospital stay (P = 0.715), as well as functional outcome at discharge (P = 0.332) between the two groups.

Conclusions: Our preliminary results showed that long-term low-dose aspirin use was not associated with worse outcomes. Early surgery can be safe for ruptured intracranial aneurysms in patients with long-term aspirin use.

Keywords: Antiplatelet; Aspirin; Early surgery; Intracranial aneurysm; Subarachnoid hemorrhage.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Bleeding events associated with the aspirin group and non-aspirin group: the rate of patients according to intraoperative blood loss (a), and the incidence of postoperative hemorrhagic events (b)
See this image and copyright information in PMC

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