AGE AND GENDER INFLUENCE SURVIVAL AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Allison O'Handley, Emma Slas, Yuefang Chang, PhD, Elizabeth Crago, RN, PhD (faculty mentor) Department of Acute and Tertiary Care University of Pittsburgh School of Nursing 336 Victoria Building 3500 Victoria Street Pittsburgh, PA 15261

Aneurysmal subarachnoid hemorrhage (aSAH) is bleeding into the arachnoid space of the brain due to a ruptured blood vessel and is associated with high morbidity and mortality. Unfavorable outcomes have been associated with factors such as injury severity, older age and female gender. The purpose of this analysis was to examine if differences in outcomes by gender varied by age categories. This retrospective longitudinal study recruited 738 persons (age 18-83 years; 73% female), with confirmed aSAH from a comprehensive stroke center (R01NR04339; R01HL074316). Age categories were predetermined by sample distribution as < 35; 36-45; 46-55; 56-65; and > 66 years. Severity of injury was determined by Hunt and Hess scores (HH) documented on hospital admission. Modified Rankin Score (mRS) was obtained at 3 and 12 months after aSAH to determine functional outcome [good (0,1,2) versus poor (3,4,5)] and survival. Relationships between variables were evaluated using ANOVA, t-Tests and Spearman correlations using SAS and SPSS, followed by logistic regression analyses to control for significant covariates (HH p<.001). Older age was associated with significant differences in survival at both 3 (p=.008) and 12 months (p=.01) after aSAH; but not when controlling for HH (p=.09; p=.13 respectively). When examining outcomes by gender, only female subjects had significant differences by age category with increasing age associated with mortality at 3 (p=.008) and 12 months (p=.01) after aSAH. This relationship remained significant at 3 months (p=.04) and trended at 12 months (p=.06) even when controlling HH. In aSAH patients who survived, no significant differences were observed in mRS by age category or gender. These results suggest that survival after aSAH is not associated with age and gender independently. Instead, differences in outcomes is influenced by the presence of both older age and female gender. Research is ongoing to further elucidate these differences.


Additional Abstract Information

Presenter: Allison O'Handley

Institution: University of Pittsburgh School of Nursing

Type: Oral

Subject: Nursing

Status: Approved


Time and Location

Session: Oral 4
Date/Time: Thu 3:40pm-4:00pm
Location: Old North 211
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