Descriptive and predictive study of endovascular treatment of intracranean aneurisms: Retrospective analysis of 258 cases.

Solapas principales

Spagnuolo E.1,Crosa R. 2, Jaume A.3,Moreno L.4,Negrotto M.5

 

ABSTRACT

The HSA is a relatively common condition, constituting a disease of great impact on society, the high percentage of mortality presented. 80-85% of HSA is ruptured aneurysm.
Objectives: a) describe and predict mortality and morbidity aneurysms according to the initial clinical status and treatment instituted; and b) indicate that covariates are the most impact on patient mortality.

Methods: All patients were treated intracranial aneurysms, endovascular treatment, from February 2009 to August 2013, in the center of Endovascular Neurosurgery CEDIVA included. The surveyed variables were: personal data, causal variables (smoking, hypertension), indicators of the patient (Hunt and Hess scale, scale WFNS, Fisher scale), aneurysm descriptive variables (size, location), type of treatment, complications, and control variables (arteriography control and GOS at one and six months)

Mortality in the training sample was 16% with 11% morbidity and a good recovery in 73% of patients; with an error of 5%. If we consider the case of Hunt and Hess 1, 2 and 3, the step to be expected proportion of 5% with an error of 4%. The total prediction error was 10% with 9% rate of false positives, 1% of false negatives.

From the RF(random forest) algorithm can determine the order of importance of variables: Hunt and Hess, WFNS, location, Fisher, age and size.

 

Keywords:  meningeal hemorrhage, treatment of aneurysms, embolization, surgery, prognosis

 

1. Neurocirujano, Jefe del servicio Neurocirugía, Hospital Maciel , ASSE.

2. Neurointervencionista, Jefe del servicio CEN, Montevideo, Uruguay.

3. Residente de Neurocirugía, Hospital de Clínicas Montevideo, Uruguay.

4. Docente Departamento de Métodos Cuantitativos,  CCEE, Universidad de la República. Uruguay.

5. Matías Negrotto, Residente de Radiología, Hospital de Clínicas, Montevideo, Uruguay.

 

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