Statistical analysis of factors affecting the outcome of patients with ruptured distal anterior cerebral artery aneurysms

The clinical factors affecting the outcome of patients with ruptured distal anterior cerebral artery (ACA) aneurysms were analyzed using multiple logi stic regression analysis. The medical records were reviewed of 52 patients (57 aneurysms) with ruptur ed distal ACA aneurysms operated on by the same neurosurgeon over 25 years. The standard policy was early surgery for patients in Hunt and Kosnik grad es I to IV. Age, sex, Hunt and Kosnik grade, timing of operation, size of a neurysms, number of aneurysms, association of intracerebral haemorrhage (IC H), intraventricular haemorrhage, and azygos ACA, use of temporary clipping , occurrence of premature rupture, and presence of psychiatric change were investigated. Univariant analysis disclosed that clinical grade (P = 0.0006 ), size of aneurysm (P = 0.005), and size of ICH (P = 0.012) affected the o utcome of patients. Multiple logistic regression analysis found that Hunt a nd Kosnik grade(P = 0.010) and timing of operation (P = 0.033) affected the outcome. There was no significant relationship between long-term outcome a nd clinical factors, although a close relationship was found with Hunt and Kosnik grade (P = 0.071). Clinical grade and timing of the operation affected the outcome of patients with ruptured distal ACA aneurysms. Patients harboring ICH of over 3 cm di ameter in poor grades should also be carefully treated.