Predictive value of the Glasgow Coma Scale for postoperative functional outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study (2018–2021)

Condori-Jara G.; Acha-Sanchez J.; Amado-Tineo J. · Ukrainian Neurosurgical Journal (2026) · DOI: 10.25305/unj.350494

Resumen

Introduction: The Glasgow Coma Scale (GCS) is a widely used tool for assessing the level of consciousness and predicting prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, its specific predictive value in the Peruvian context and its relationship with functional outcomes have not been sufficiently studied. Objective: To determine the association between the admission GCS score and functional outcomes, measured by the modified Rankin Scale (mRS), in patients undergoing microsurgical clipping at the Hospital Nacional Dos de Mayo between 2018 and 2021. Methods: This was a retrospective longitudinal observational study. Medical records of patients who underwent surgery in the Neurosurgery Service between 2018 and 2021 were retrospectively reviewed. The main variables were admission GCS score and postoperative mRS scores at discharge and at 6 months (good outcome: mRS 0–3 or poor outcome: mRS 4–6). Chi-square or Fisher's exact test was used for bivariate analysis, and Student's t-test or Mann-Whitney U test for quantitative variables, with a 95% confidence interval. Results: A total of 189 patients were included, predominantly female (67.7%), with a mean age of 53 ± 15.09 years and arterial hypertension (56.6%). According to GCS severity was classified as mild (64.6%), moderate (33.9%), and severe (1.6%). At 6 months, 94.1% achieved good functional outcomes. A significant association was found between higher GCS scores and better functional outcomes at discharge (p=0.004), at 3 months (p<0.001), and at 6 months (p<0.001). The minipterional approach demonstrated superior functional outcomes compared to the conventional pterional approach. Conclusions: Higher admission GCS scores were associated with better postoperative functional outcomes in patients undergoing microsurgical clipping for anterior circulation aneurysms.

Instituciones: Universidad Nacional Mayor de San Marcos