To explore the risk factors affecting the poor prognosis of neurological function in elderly patients with subarachnoid hemorrhage (SAH), and to analyze the relationship between the prognosis of neurological function and age cut-off in SAH patients.

Two hundred and twelve elderly patients with SAH who underwent surgical treatment from January 2010 to December 2015 in the Characteristic Medical Center of Armed Police Force (Affiliated Hospital of Armed Police Logistics College) were collected. The neurological function prognosis of SAH patients was analyzed one year after operation. Logistic regression analysis was used to analyze the relevant factors that affected the prognosis of SAH. The ROC curve was drawn to determine the age cut-off that affected the prognosis of neurological function of patients. According to the different surgical methods, the patients were divided into clip group and embolization group, and the related data of the two groups were compared.

Multivariate Logistic regression analysisshowed that age and high Hunt-Hess(H-H) grade (4-5) and Fisher high grade (3-4) were risk factors for poor prognosis in elderly patients with SAH. ROC curve showed that the best cut-off value for age to predict poor prognosis in elderly patients with SAH was 70 years old (sensitivity: 89.3%; specificity: 28.4%; accuracy: 87.7%). There was no statistical difference in the H-H grade (grade 1-3) at admission between the two groups. The rate of 1-year good prognosis of the clip group (60-70 years old, low H-H grade) was 83.3%, and the embolization group was 88.3%. The 1-year good prognosis of the clip group (>70 years old, low H-H grade) was 18.8%, and the embolization group was 32.8%. The difference of good prognosis rate was statistically significant (P<0.05).

The prognosis of neurological dysfunction in elderly patients with SAH was related to the severity of the patient’s condition (H-H classification) and age cut-off (> 70 years old) at the time of admission, and is not related to the choice of treatment (craniotomy aneurysm clipping or endovascular embolization therapy).