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Lookup NU author(s): Dr Jonathan Barnes, Patrick Mitchell
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Object. The pathophysiology of aneurysmal subarachnoid hemorrhage (aSAH) is unclear. Sex may play a role in the outcome of patients with aSAH.Methods. The authors retrospectively identified 617 patients with aSAH (April 2005 to February 2010) and analyzed sex differences in risk factors (age, hypertension, smoking, alcohol consumption, and family history), admission-related factors (World Federation of Neurosurgical Societies grade and admission delay), aneurysm characteristics (site, side, location, and multiplicity), and outcomes (treatment modalities [coiling/clipping/both/conservative], complications [vasospasm and hydrocephalus], length of stay, and modified Rankin Scale score at 3 months).Results. The female patients with aSAH were older than the male patients (mean age 56.6 vs 51.9 years, respectively, p <0.001), and more women than men were 55 years old (56.2% vs 40.4%, respectively, p <0.001). Women exhibited higher rates of bilateral (6.8% vs 2.6%, respectively, p <0.05), multiple (11.5% vs 5.2%, respectively, p < 0.05), and internal carotid artery (ICA) (36.9% vs 17.5%, respectively, p <0.001) aneurysms and a lower rate of anterior cerebral artery aneurysms (26.3% vs 44.8%, respectively, p < 0.001) than the men, but no side differences were noted. There were no sex differences in risk factors, admission-related factors, or outcome measures. For both sexes, outcomes varied according to aneurysm location, with odds ratios for a poor outcome of 1.62 (95% CI 0.91-2.86, p = 0.1) for middle cerebral artery, 2.41 (95% CI 1.29-4.51, p = 0.01) for ICA, and 2.41 (95% CI 1.29-4.51, p = 0.006) for posterior circulation aneurysms compared with those for anterior cerebral artery aneurysms. The odds ratio for poor outcome (modified Rankin Scale score of 4-6) in women compared with men after adjusting for significant prognostic factors was 0.71 (95% CI 0.45-1.11, p > 0.05).Conclusions. The overall outcomes after aSAH between women and men are similar.
Author(s): Hamdan A, Barnes J, Mitchell P
Publication type: Article
Publication status: Published
Journal: Journal of Neurosurgery
Year: 2014
Volume: 121
Issue: 6
Pages: 1367-1373
Print publication date: 01/12/2014
Online publication date: 12/09/2014
Acceptance date: 29/07/2014
ISSN (print): 0022-3085
ISSN (electronic): 1933-0693
Publisher: American Association of Neurological Surgeons
URL: http://dx.doi.org/10.3171/2014.7.JNS132318
DOI: 10.3171/2014.7.JNS132318
PubMed id: 25216063
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