The aim of this study was to clarify the association between the outcomes of patients with subarachnoid hemorrhage (SAH) and various therapeutic risk factors. Endovascular therapy is performed in elderly patients at many institutions as a minimally invasive procedure. However, the appropriate treatment is planned for patients across all age groups at our institution considering the safety aspects of each procedure.

A total of 327 patients were admitted at our institution, between March 2005 and July 2018, due to non-traumatic SAH. Patients with non-aneurysmal SAH, hematoma, and posterior fossa artery dissection, and those who required special procedures such as arterial anastomosis were excluded from the study. Finally, we analyzed 243 patients who underwent surgery for treatment of aneurysmal SAH. Multivariable logistic regression analysis was performed to assess the independent association between the outcomes and certain therapeutic risk factors. Patients were graded on admission based on the World Federation of Neurological Surgeons (WFNS) grading system, and the modified Rankin Scale (mRS) was used to evaluate the outcomes at discharge. The therapeutic risk factors assessed in the multivariable adjustment model were age (at every 5-year interval), sex, method of treatment, WFNS grade (at every 1 grade higher), and shunt dependence (yes/no). The mean age of the patients was 63 years, and 172 patients were women. Only the WFNS grade was associated with the mRS after adjusting for covariates, although there was no association between the mRS and age, except in cases of ruptured aneurysm in the anterior communicating artery.

We concluded that the outcomes at discharge varied based on WFNS grade alone and were not affected by age, except in cases of ruptured aneurysm in the anterior communicating artery.