• Helena Aineskog, Bryndís Baldvinsdóttir, Elisabeth Ronne Engström, Johanna Eneling, Per Enblad, Mikael Svensson, Peter Alpkvist, Steen Fridriksson, Paula Klurfan, Jan Hillman, Erik Kronvall, Ola G Nilsson, and Peter Lindvall.
• Department of Clinical Sciences - Neurosciences, Umeå University, Umeå, Sweden. Electronic address: helena.aineskog@regionvasterbotten.se.
• World Neurosurg. 2024 Oct 1; 190: e513e524e513-e524.

ObjectiveTo study associations of clinical characteristics and treatment choice with functional outcome, mortality, and time to death in a national sample of aneurysmal subarachnoidal hemorrhage patients.MethodsData were extracted from a prospective nationwide multicenter study performed in September 2014 to March 2018. Glasgow Outcome Scale Extended (GOSE) grade, 1-year mortality, and survival probability were assessed at one year after ictus. Logistic univariate, multivariate, and Cox regression analyses were used to study the variables' associations with the outcomes.ResultsUnfavorable dichotomized GOSE (dGOSE; grades 1-4) was observed in 35.4% of patients. Microsurgery was preferred for middle cerebral artery aneurysms and Fisher grade 4. Treatment modality was not associated with any outcome measure. Dichotomized World Federation of Neurosurgical Societies (dWFNS), age, and delayed ischemic neurological deficit (DIND) showed significant correlations with dGOSE and 1-year mortality in multivariate regression analyses. Pupil dilatation was associated with a 1-year mortality outcome. Cox regression analysis showed lower survival probability for pupil dilatation (hazard ratio [HR]: 3.546), poor dWFNS (HR: 3.688), higher age (HR: 1.051), and DIND occurrence (HR: 2.214).ConclusionsThe patient selection in Sweden after aneurysmal subarachnoidal hemorrhage showed similar values for dGOSE, 1-year mortality, and survival probability between patients treated with microsurgery or endovascular technique. Poor dWFNS, higher age, and DIND were significantly associated with unfavorable dGOSE, mortality, and survival probability. Pupil dilatation was significantly associated with mortality and survival probability.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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