One-year outcome after aneurysmal subarachnoid hemorrhage in elderly patients

Abstract Background The number of elderly aneurysmal subarachnoid hemorrhage (aSAH) patients admitted to intensive care units (ICU) has increased. We aimed to analyze the characteristics and outcomes of such patients in a tertiary university hospital during a five-year period. Methods A retrospective, single-center analysis of aSAH patients ≥70y old admitted to a tertiary neuro-ICU during January 2014–May 2019 based on medical records and computed tomography scans. The primary outcome was functional outcome at 12 months. We used multivariable logistic regression to assess factors associated with unfavorable outcome (Glasgow Outcome Scale 1-3 and institutionalized). Results Of 117 included patients, 49 % had a favorable outcome at 12 months, while mortality was 41 %. In multivariable analysis, poor grade aSAH and intraventricular hemorrhage were predictors of poor outcome (odds ratio 4.7, 95 % CI 1.7-12.5 and 2.8, 95 % CI 1.1-7.2, respectively). None of the patients with a Glasgow Coma Scale (GCS) motor score 1-3 three days after admission were alive at 12 months. In contrast, 65% of those with a GCS motor score 6 had favorable outcome. Conclusions Half of elderly aSAH patients admitted to a neuro-ICU were able to live at home after 12 months. Mortality was significant, but the number of severely disabled patients was low. Clinical status at admission was the strongest predictor of outcome, while intraventricular hemorrhage increased the risk of poor outcome as well. GCS motor score three days after admission seemed to predict mortality and outcome.