Predictors of full functional recovery in endovascularly treated patients with aneurysmal subarachnoid hemorrhage

Abstract

Background/aim: The knowledge of factors influencing functional outcomes after aneurysmal subarachnoid hemorrhage (ASH) has significantly increased in recent decades, still not enough. We aimed to identify the predictors of full functional recovery (FFR) in endovascularly treated patients with ASH.

Materials and methods: A retrospective review was performed of adult patients who underwent endovascular treatment for ASH in a 5-year period. The association was evaluated of variables with FFR, defined as a modified Rankin Scale score of 0 or 1 at a 3-month follow-up.

Results: This study included 204 patients with a percentage of FFR of 62.7%. On univariate analysis, the following variables were associated with FFR: younger age, male sex, no history of hypertension, posterior circulation aneurysm, better modified-Fisher grade (mFG), better Hunt-Hess grade, better Glasgow Coma score, lower platelet-to-lymphocyte ratio (PLR), lower neutrophil-to-lymphocyte ratio (NLR), and higher platelet-to-neutrophil ratio (PNR). On multivariate analysis, younger age (OR = 0.95, 95% Cl = 0.92–0.98, p = 0.003), better mFG (OR = 0.66, 95% Cl = 0.48–0.97, p = 0.03), lower PLR (OR = 0.993, 95% Cl = 0.990–0.997, p = 0.001), lower NLR (OR = 0.89, 95% Cl = 0.83–0.95, p = 0.01) and higher PNR (OR = 1.08, 95% Cl = 1.01–1.10, p = 0.01) showed the strongest association with FFR.

Conclusion: With the administration of endovascular treatment, most of the patients with ASH can return to a normal productive life. Younger age, better mFG, lower PLR and NLR, as well as higher PNR, increase the likelihood of FFR.

Keywords: Subarachnoid hemorrhage; cerebral aneurysm; outcome; prediction.

Figure 1

Flow chartshowing the selection ofthe study population.