{"title":"Comparison of postoperative cognitive function in patients undergoing surgery for ruptured and unruptured intracranial aneurysm","authors":"Yasunari Otawara MD , Kuniaki Ogasawara MD , Yoshitaka Kubo MD , Hiroshi Kashimura MD , Akira Ogawa MD , Keiko Yamadate BSc","doi":"10.1016/j.surneu.2009.06.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Patients with SAH often experience cognitive decline. Previous studies used normal volunteers, published normal test values, and orthopedic patients as controls to identify factors for postoperative cognitive decline. The present study excluded the effects of surgery by comparing cognitive function after surgical repair in patients with aneurysmal SAH and patients with unruptured intracranial aneurysm.</p></div><div><h3>Methods</h3><p>This study recruited 117 patients with SAH due to ruptured aneurysm and 39 patients with incidentally found unruptured intracranial aneurysms. The cognitive test battery consisted of the Japanese translation of the WAIS-R, the Japanese translation of the WMS, and the recall trial of the ROCF. Postoperative neuropsychological test scores for the patients with SAH and control subjects were compared using group-rate and event-rate analysis. The relationship between clinical variable and postoperative cognitive decline in the patients with SAH was evaluated by univariate analysis using the Mann-Whitney <em>U</em> test or <em>χ</em><sup>2</sup> test.</p></div><div><h3>Results</h3><p>Group-rate analysis showed that the WAIS-R and ROCF scores were significantly lower in the SAH group than in the control group. Event-rate analysis demonstrated that the incidence of cognitive decline in the patients with SAH (73 [62.4%] of the 117 patients) was significantly higher than that in the control subjects (12 [30.8%] of 39 patients). The Hunt and Hess grade was significantly higher in patients with postoperative cognitive decline.</p></div><div><h3>Conclusion</h3><p>The cognitive function after SAH was significantly correlated with Hunt and Hess grade on admission when using patients with postoperative unruptured intracranial aneurysm as the control group.</p></div>","PeriodicalId":22153,"journal":{"name":"Surgical Neurology","volume":"72 6","pages":"Pages 592-595"},"PeriodicalIF":0.0000,"publicationDate":"2009-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.surneu.2009.06.016","citationCount":"21","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Neurology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0090301909005813","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 21
Abstract
Background
Patients with SAH often experience cognitive decline. Previous studies used normal volunteers, published normal test values, and orthopedic patients as controls to identify factors for postoperative cognitive decline. The present study excluded the effects of surgery by comparing cognitive function after surgical repair in patients with aneurysmal SAH and patients with unruptured intracranial aneurysm.
Methods
This study recruited 117 patients with SAH due to ruptured aneurysm and 39 patients with incidentally found unruptured intracranial aneurysms. The cognitive test battery consisted of the Japanese translation of the WAIS-R, the Japanese translation of the WMS, and the recall trial of the ROCF. Postoperative neuropsychological test scores for the patients with SAH and control subjects were compared using group-rate and event-rate analysis. The relationship between clinical variable and postoperative cognitive decline in the patients with SAH was evaluated by univariate analysis using the Mann-Whitney U test or χ2 test.
Results
Group-rate analysis showed that the WAIS-R and ROCF scores were significantly lower in the SAH group than in the control group. Event-rate analysis demonstrated that the incidence of cognitive decline in the patients with SAH (73 [62.4%] of the 117 patients) was significantly higher than that in the control subjects (12 [30.8%] of 39 patients). The Hunt and Hess grade was significantly higher in patients with postoperative cognitive decline.
Conclusion
The cognitive function after SAH was significantly correlated with Hunt and Hess grade on admission when using patients with postoperative unruptured intracranial aneurysm as the control group.
背景:SAH患者通常会出现认知能力下降。先前的研究使用正常志愿者、已公布的正常测试值和骨科患者作为对照,以确定术后认知能力下降的因素。本研究通过比较动脉瘤性SAH患者和未破裂颅内动脉瘤患者手术修复后的认知功能,排除手术的影响。方法选取117例颅内动脉瘤破裂并发SAH患者和39例意外发现颅内未破裂动脉瘤患者。认知测试组由WAIS-R的日文翻译、WMS的日文翻译和ROCF的回忆试验组成。采用组率和事件率分析比较SAH患者和对照组术后神经心理测试得分。采用单因素分析,采用Mann-Whitney U检验或χ2检验评价临床变量与SAH患者术后认知能力下降的关系。结果组率分析显示,SAH组WAIS-R和ROCF评分明显低于对照组。事件率分析显示,SAH患者的认知能力下降发生率(117例患者中73例[62.4%])显著高于对照组(39例患者中12例[30.8%])。术后认知能力下降患者的Hunt和Hess评分明显更高。结论以颅内动脉瘤术后未破裂患者为对照组,SAH后的认知功能与入院时的Hunt and Hess评分有显著相关。