Clinical Analysis of Early Operated Aneurysms in Elderly Patients

Jeing, Jin Whan; Kang, Sung Don; Kim, Jong Moon

Abstract

To determine the characteristics of elderly patients with aneurysm surgery, various clinical variables in 40 elderly cases aged over 60 years among a total of 88 patients with early operated aneurysms during past 2 years were compared with that in 48 younger cases aged under 60 years. Factors evaluated in this studies were aged, sex, location of aneurysm, size of aneurysm, hemorrhage type on brain CT, Fisher's subarachnoid hemorrhage, Hunt- Hess grade on admission, surgical outcome on discharge, incidence of vasospasm and general postoperative complication. 1) Almost one-half(40) of the 88 patients were aged 60 years or older(mean ; 57.7 years). 2) The male to female ratio was 1 : 1.84 but female was more predominant over the age og 60. 3) Location of aneurysm, size of aneurysm, mean blood pressure on admission, hemorrhage type on brain CT, Fisher's SAH grade and general postoperative complications were not related to age. 4) The proportion of elderly patients of Hunt-Hess grade 3-5 was significantly higher than that of younger patients(p<0.05). 5) The surgical outcome was significantly poorer in elderly group(p<0.05). 6) The incidence of symptomatic vasospasm was significantly higher in the elderly group(p<0.05). 7) The surgical outcome was no significantly differance of same Hunt-Hess grade between elderly group and younger group. These results suggest that the high incidence of older patients is more consistent with a degenerative etiology than a development defect and among elderly patients poor outcome following early surgery is attributable to high incidence of poor preoperative neurological status and vasospasm.