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Clinical outcomes and prognostic factors in patients with spinal dural arteriovenous fistulas : a prospective cohort study in two Chinese centres

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机构: [1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [2]International Neuroscience Institute, Beijing, China [3]Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China [4]Department of Neurosurgery, Beijing Haidian Hospital, Beijing, China [5]Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota, USA
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关键词: embolisation neurosurgical treatment outcome prognostic factors spinal dural arteriovenous fistula

摘要:
Background The short-term outcomes and prognostic factors of patients with spinal dural arteriovenous fistulas (SDAVFs) have not been defined in large cohorts. Objective To define the short-term clinical outcomes and prognostic factors in patients with SDAVFs. Methods A prospective cohort of 112 patients with SDAVFs were included consecutively in this study. The patients were serially evaluated with the modified Aminoff and Logue's Scale (mALS) one day before surgery and at 3 months, 6 months and 12 months after treatment. Univariate and multivariate analyses were performed to identify demographic, clinical and procedural factors related to favourable outcome. Results A total of 94 patients (mean age 53.5 years, 78 were men) met the criteria and are included in the final analyses. Duration of symptom ranged from 0.5 to 66 months (average time period of 12.7 months). The location of SDAVFs was as follows: 31.6% above T7 level, 48.4% between T7 and T12 level (including T7 and T12) and 20.0% below T12 level. A total of 81 patients (86.2%) underwent neurosurgical treatment, 10 patients (10.6%) underwent endovascular treatment, and 3 patients (3.2%) underwent neurosurgical treatment after unsuccessful embolisation. A total of 78 patients demonstrated an improvement in mALS score of one point or greater at 12 months. Preoperative mALS score was associated with clinical improvement after adjusting for age, gender, duration of symptoms, location of fistula and treatment modality using unconditional logistic regression analysis (p<0.05). Conclusion Approximately four fifths of the patients experienced clinical improvement at 12 months and preoperative mALS was the strongest predictor of clinical improvement in the cohort.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2016]版:
Q1 MEDICINE, GENERAL & INTERNAL
最新[2024]版:
Q2 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2024版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [2]International Neuroscience Institute, Beijing, China
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通讯机构: [1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China [2]International Neuroscience Institute, Beijing, China
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