机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China神经外科首都医科大学宣武医院[2]International Neuroscience Institute, Beijing, China[3]Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China首都医科大学宣武医院[4]Department of Neurosurgery, Beijing Haidian Hospital, Beijing, China[5]Zeenat Qureshi Stroke Institute, St. Cloud, Minnesota, USA
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.
基金:
the National Natural Science Foundation of China (Award Number: 81171165;81671202);
Beijing Municipal Science and Technology Commission (Award Number: D161100003816001).
第一作者机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China[2]International Neuroscience Institute, Beijing, China
通讯作者:
通讯机构:[1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China[2]International Neuroscience Institute, Beijing, China
推荐引用方式(GB/T 7714):
Yongjie Ma ,Sichang Chen ,Chao Peng ,et al.Clinical outcomes and prognostic factors in patients with spinal dural arteriovenous fistulas : a prospective cohort study in two Chinese centres[J].BMJ OPEN.2018,8(1):e019800.doi:10.1136/bmjopen-2017-019800.
APA:
Yongjie Ma,,Sichang Chen,,Chao Peng,,Chunxiu Wang,,Guilin Li,...&Hongqi Zhang.(2018).Clinical outcomes and prognostic factors in patients with spinal dural arteriovenous fistulas : a prospective cohort study in two Chinese centres.BMJ OPEN,8,(1)
MLA:
Yongjie Ma,,et al."Clinical outcomes and prognostic factors in patients with spinal dural arteriovenous fistulas : a prospective cohort study in two Chinese centres".BMJ OPEN 8..1(2018):e019800