Quality of Life in Elderly After Aneurysmal Subarachnoid Hemorrhage (SAH)

NCT ID: NCT00692744

Last Updated: 2014-09-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

353 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-10-31

Study Completion Date

2014-01-31

Brief Summary

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In all the Western populations, the annual incidence of subarachnoid hemorrhage (SAH) increase with age. In patients older than 70 years, the occurrence of SAH exposes them to high risk of morbidity and a poor quality of life.

In this age bracket, the single randomized which compared endovascular coiling to microsurgical clipping (ISAT Study) showed that the relative risk of morbidity increased after coiling. Moreover, some prospectives studies about endovascular coiling described favorable outcome in 48% to 63% of patients, complete occlusion in 51% to 69% and a procedural complication rate in 13% to 19%. From prospectives series, the proportion of favorable outcome after microsurgical clipping was estimated around 66% but the procedural complications are few reported. The outcome for patients treated conservatively was catastrophic. Lastly, the hydrocephalus in this age class is common, occurring in 55% of patients.

The study hypothesis is that, in this age class, no difference exists between the 2 obliteration procedures.

An accurate evaluation of result in term of functional disability, quality of life and prognosis predictive factors seems a judicious question.

Detailed Description

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The aim of our study was to determine a significant difference in terms of functional disability between microsurgical clipping and endovascular coiling in the elderly population.

Randomized multicenter trial: 2 randomized arms (clipping and coiling) plus 3 observational prospective arms (clipping, coiling, conservative).

Inclusion time: 48 months. Follow up: 12 months. Monitoring: 6 months. Duration of the trial: 66 months. Major end point: proportion of patients with unfavourable outcome at 12 months (mRS \> 2).

Secondary end point: Quality of life at 12 months (EORTC scale), causes of morbidity (mRS \> 2) and mortality, Dysautonomia according to the ADL and IADL scales.

Conditions

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Aneurysmal Subarachnoid Hemorrhage Hydrocephalus Cerebral Vasospasm

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Randomized microsurgical

After randomization, this group was constituted of patients treated by microsurgical clipping.

No interventions assigned to this group

Randomized endovascular

After randomization, this group was constituted of patients treated by endovascular coiling.

No interventions assigned to this group

Prospective observational microsurgical

The randomization was ethically unsuitable because of the aneurysm predisposed to the microsurgical clipping after discussion into the neurovascular interdisciplinary team.

No interventions assigned to this group

Prospective observational endovascular

The randomization was ethically unsuitable because of the aneurysm morphology predisposed to the endovascular coiling after discussion into the neurovascular interdisciplinary team.

No interventions assigned to this group

Prospective observational conservative

This group was constituted of patients whom no curative treatment of the aneurysm sac could not be proposed.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* 70 years old and more
* Subarachnoid hemorrhage in grade I-IV of WFNS scale
* Ruptured cerebral aneurysm diagnosed on multislice computed tomography angiography or cerebral angiography
* treatment of subarachnoid hemorrhage

Exclusion Criteria

* Patients in grade V of WFNS scale
* Subarachnoid hemorrhage without cerebral aneurysm
* Patients with cerebral dementia, neurologic or psychiatric antecedents
Minimum Eligible Age

70 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Rouen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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François PROUST, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Rouen

Serge BRACARD, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Central Hospital, Nancy, France

Guillaume PENCHET, M.D.

Role: STUDY_DIRECTOR

University Hospital, Bordeaux

Evelyne EMERY, M.D.

Role: STUDY_DIRECTOR

University Hospital, Caen

Bernard IRTHUM, M.D.

Role: STUDY_DIRECTOR

Clermont University Hospital

Klaus MOURIER, M.D.

Role: STUDY_DIRECTOR

Centre Hospitalier Universitaire Dijon

Emmanuel GAY, M.D.

Role: STUDY_DIRECTOR

University Hospital, Grenoble

Jean-Paul LEJEUNE, M.D.

Role: STUDY_DIRECTOR

Lille University Hospital

Isabelle PELISSOU, M.D.

Role: STUDY_DIRECTOR

Hospices Civils de Lyon

Pierre Hughes ROCHE, M.D.

Role: STUDY_DIRECTOR

University Hospital, Marseille

Thierry CIVIT, M.D.

Role: STUDY_DIRECTOR

Central Hospital, Nancy, France

Michel LONJON, M.D.

Role: STUDY_DIRECTOR

Nice University Hospital

Philippe DAVID, M.D.

Role: STUDY_DIRECTOR

Paris University Hospital

Benoit BATAILLE, M.D.

Role: STUDY_DIRECTOR

Poitiers University Hospital

Xavier MORANDI, M.D.

Role: STUDY_DIRECTOR

Rennes University Hospital

Jacques LAGUARRIGUE, M.D.

Role: STUDY_DIRECTOR

University Hospital, Toulouse

Romain BILLON-GRAND, M.D.

Role: STUDY_DIRECTOR

Besançon University Hospital

Damien BRESSON, M.D.

Role: STUDY_DIRECTOR

Paris University Hospital

Locations

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PROUST

Rouen, , France

Site Status

Rouen University Hospital

Rouen, , France

Site Status

Countries

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France

References

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Proust F, Gerardin E, Derrey S, Lesveque S, Ramos S, Langlois O, Tollard E, Benichou J, Chassagne P, Clavier E, Freger P. Interdisciplinary treatment of ruptured cerebral aneurysms in elderly patients. J Neurosurg. 2010 Jun;112(6):1200-7. doi: 10.3171/2009.10.JNS08754.

Reference Type BACKGROUND
PMID: 19961311 (View on PubMed)

Proust F, Bracard S, Thines L, Leclerc X, Penchet G, Berge J, Vignes JR, Irthum B, Gabrillargues J, Chazal J, Bataille B, Drouinau J, Mourier K, Ricolfi F, Gay E, Bessou P, Lonjon M, Sedat J, David P, Lajaunias P, Morandi X, Gauvrit JY, Pelissou I, Turjman F, Roche PH, Dufour H, Levrier O, Emery E, Courtheoux P, Laguarrigue J, Cognard C, Civit T, Lejeune JP. [Aneurismal subarachnoid hemorrhage in the elderly subject. Should this patient participate in a randomized clinical trial?]. Neurochirurgie. 2010 Feb;56(1):67-72. doi: 10.1016/j.neuchi.2009.11.002. Epub 2010 Jan 8. No abstract available. French.

Reference Type BACKGROUND
PMID: 20060549 (View on PubMed)

Other Identifiers

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2007/042/HP

Identifier Type: -

Identifier Source: org_study_id

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