Modified Rankin Scale and Short-Term Outcome in Cranial Neurosurgery : A Prospective and Unselected Cohort Study

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http://hdl.handle.net/10138/224568

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Reponen , E , Tuominen , H , Hernesniemi , J & Korja , M 2016 , ' Modified Rankin Scale and Short-Term Outcome in Cranial Neurosurgery : A Prospective and Unselected Cohort Study ' , World Neurosurgery , vol. 91 , pp. 567-+ . https://doi.org/10.1016/j.wneu.2016.03.102

Title: Modified Rankin Scale and Short-Term Outcome in Cranial Neurosurgery : A Prospective and Unselected Cohort Study
Author: Reponen, Elina; Tuominen, Hanna; Hernesniemi, Juha; Korja, Miikka
Contributor: University of Helsinki, Anestesiologian yksikkö
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Clinicum
University of Helsinki, Neurokirurgian yksikkö
Date: 2016-07
Language: eng
Number of pages: 14
Belongs to series: World Neurosurgery
ISSN: 1878-8750
URI: http://hdl.handle.net/10138/224568
Abstract: BACKGROUND: The modified Rankin Scale (mRS) was developed to monitor functional recovery after stroke, but nowadays it is a treatment outcome measure in elective neurosurgery. Our objective was to study how mRS changes associate with short-term postoperative outcome. METHODS: Preoperative, in-hospital, and 30-day mRS scores came from a prospective, consecutive and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 in Helsinki, Finland. Recorded data included subjective and objective postoperative in-hospital complications as well as changes in mRS score after surgery. RESULTS: Minor or major complications were detectable in 46% of the patients. In-hospital and 30-day postoperative increases in mRS score were inconsistent; among patients with no complications, 17% had a greater mRS score at discharge and 24% at 30 days, whereas 28% of the patients with major complications showed no increase in mRS score at discharge. Of individual complications, only new or worsened hemiparesis, silent stroke, and pneumonia were associated with postoperative increase (>2) in mRS score after multivariable analysis. For mRS-score difference >1 at discharge in detecting major complications (including mortality), sensitivity was 45% and specificity 94%. CONCLUSIONS: The mRS changes after elective cranial neurosurgery are inconsistent. The mRS seems to represent functional changes, which do not necessarily associate with detected in-hospital complications.
Subject: Craniotomy
modified Rankin Scale
Outcome
UNRUPTURED INTRACRANIAL ANEURYSMS
CEREBRAL-ARTERY ANEURYSMS
SINGLE-CENTER SERIES
ARTERIOVENOUS-MALFORMATIONS
ENDOVASCULAR COILING
RANDOMIZED-TRIAL
MANAGEMENT
SURGERY
STROKE
BRAIN
3126 Surgery, anesthesiology, intensive care, radiology
3124 Neurology and psychiatry
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