Ilari Rautalin's research while affiliated with Helsinki University Central Hospital and other places

Publications (20)

Article
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Background: Heterogeneity among study populations and treatment procedures has led to conflicting results on outcome predictors for patients with aneurysmal subarachnoid hemorrhage (aSAH). One such conflicting predictor is body mass index (BMI). Objective: To clarify whether high BMI values protect patients from poor outcome after aSAH, as previ...
Article
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Background Postoperative opioid use plays an important role in the global opioid crisis, but little is known about in-hospital opioid use trends of large surgical units. We investigated whether postoperative in-hospital opioid consumption changed in a large academic neurosurgical unit between 2007 and 2018. Methods We extracted the data of consume...
Article
Background and Purpose Several population-based cohort studies have related higher body mass index (BMI) to a decreased risk of subarachnoid hemorrhage (SAH). The main objective of our study was to investigate whether the previously reported inverse association can be explained by modifying effects of the most important risk factors of SAH—smoking...
Article
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Background: Literature is inconclusive regarding the association between antiplatelet agents use and outcome after aneurysmal subarachnoid hemorrhage (aSAH). Aims: To investigate the association between clinical outcome and prehemorrhage use in aSAH patients as well as the impact of thrombocyte transfusion on rebleed and clinical outcome. Methods...
Article
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Population aging is likely increasing the number of surgically treated very old (≥ 80–year-old) intracranial meningioma (IM) patients. Since there is little data on mortality in this patient group, we studied whether survival of surgically treated very old IM patients differs from survival of a matched general population. We retrospectively identif...
Article
Objective: To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland. Methods: By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. B...
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Since the number of elderly people with intracranial meningiomas (IM) continues to rise, surgical treatment has increasingly become a considerable treatment option, even in very old (≥ 80 years old) meningioma patients. Since little is known about whether meningioma surgery in this age group is safe and justified, we conducted a systematic review t...
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Purpose Surgical resection of intracranial meningiomas in patients that are 80 years old and older, i.e. very old patients, is increasingly considered. Meningiomas with a largest diameter of at least 5 cm—‘giant meningiomas’—form a distinct entity, and their surgical resection is considered more difficult and prone to complications. Here, we evalua...
Article
Objective Previous reports suggest that more experienced surgeons have better postoperative outcomes in neurosurgery. We studied whether this association is found in a fragile cohort of ≥80-year-old intracranial meningioma (IM) patients. Methods We identified 83 very old IM patients who were operated on by 12 different surgeons between 2010 and 20...
Article
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As the number of obese people is globally increasing, reports about the putative protective effect of obesity in life-threatening diseases, such as subarachnoid hemorrhage (SAH), are gaining more interest. This theory—the obesity paradox—is challenging to study, and the impact of obesity has remained unclear in survival of several critical illnesse...
Article
Background and purpose: One of the largest twin studies to date suggested that subarachnoid hemorrhage (SAH) is mainly of nongenetic origin, but the causal effect of environmental factors on SAH is yet unknown. We hypothesized that if only one of the twins experience fatal SAH, they do not share the most important environmental risk factor for SAH...
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PurposeTo assess the association of peritumoral brain edema (PTBE) with postoperative outcome in old (≥ 80 years) meningioma patients.Methods All supratentorial meningioma patients (≥ 80 years old) who underwent surgery between 2010 and 2018 were retrospectively identified. Patients were classified into poor (≤ 40), intermediate (50–70), or good (≥...
Article
Full-text available
Background Although most aneurysmal subarachnoid hemorrhage (aSAH) patients suffer from neuropsychological disabilities, outcome estimation is commonly based only on functional disability scales such as the modified Rankin Scale (mRS). Moreover, early neuropsychological screening tools are not used routinely. Objective To study whether two simple...
Article
Full-text available
Benefit of physical activity in prevention of aneurysmal subarachnoid hemorrhage (SAH) is unclear. We aimed to clarify this by studying how different types of physical activity associate with SAH risk. By following 65 521 population-based FINRISK participants prospectively from medical and autopsy registries since 1972 until 2014, we detected 543 i...

Citations

... We want to thank Drs Wang and Yang for their great interest and feedback regarding our recent article in Neurosurgery. 1 In their Letter, 2 Drs Wang and Yang have pointed out 4 factors, namely (1) age, (2) cohort heterogeneity, (3) aneurysm size, and (4) preoperative condition, that may have affected our presented results. In short, Drs Wang and Yang raise concerns as to whether these factors are outcome predictors in our study and, therefore, explain at least partially the reported association between high body mass index (BMI) and poor aneurysmal subarachnoid hemorrhage (aSAH) outcome. ...
... Data were subtracted from a retrospective database, based on hospital admissions. Discrepancies between administrative registry-based studies and data based on actual observational data, have been raised previously [19]. Apart from the inherent limitations related to retrospective databases, there was also missing data. ...
... Medium/large meningiomas were considered as one group for this study because they have similar prognostic features and are often variably defined in many studies [1,3,14,15,[24][25][26][27][28][29][30][31]. ...
... The study cohort has been described previously 8,11,12 . By utilizing a hospital-based electronic Centricity™ Opera (GE Healthcare) software, which is an operating theatre management solution, we identified all very old (≥ 80-year-old) patients who underwent their first-ever elective IM surgery at HUH. ...
... Spontaneous subarachnoid hemorrhage (SAH) causes 2-9% of all strokes, but it is one of the most common causes of stroke-related deaths among the middle-aged [22,25]. Ruptured intracranial aneurysms are the most common cause of spontaneous SAH (85%). ...
... [5,7] Known risk factors for the development and rupture of IAs include hypertension and smoking. [24,26] Interestingly, many patients with a saccular BTA harbor multiple aneurysms or other vascular abnormalities such as persistent primitive arteries or basilar artery fenestration. [15,26] Similar to CADs, an underlying vascular fragility is, therefore, suggested in patients with BTAs. ...
... Amano et al. compared two patient populations, less than 75 years against those greater than 75 years and did not find any differences in 30-day mortality and neurological complications [18]. Indeed, a recently published study found that patients over 80 years with peritumoral edema and poor pre-operative Karnofsky performance score (KPS) had the highest improvement in post-operative KPS, demonstrating the clear benefit of surgery in this population [33]. Others found progressive improvement in long-term neuropsychological functioning after surgery for intracranial meningioma resection in patients over a median age of 74 years [34]. ...
... Therefore, we have also included as a supplemental CDE, the availability of tumor tissue and plasma, that can be available for transfer between centers. [29][30][31][32][33][34][35][36][37][38] Date of primary surgery 30,32,33,39,40 Biological sex [41][42][43][44][45][46] Race/ethnicity [41][42][43][44][47][48][49] Country of diagnosis and care [50][51][52][53][54][55] Hispanic race 47,48,56 Diagnosis of neurofibromatosis 2 40,57-65 Diagnosis of meningioma syndrome [64][65][66][67][68][69][70] Lifetime history of malignancy 58,71 Vital status 72-76 ...
... 18 This theory is probably even more true for the treatment of ACoAAs, in which cognitive and neuropsychological deficits are described relatively frequently, 36 and such deficits are often missed with mRS sores. 37 Nonetheless, the mRS score was included to enable a comparison with previous studies. Future studies of the treatment of unruptured ACoAAs should consider reporting outcome from a broader and societal perspective, including cognitive functioning, quality of life, and return-to-work rates. ...
... This finding was intriguingly opposite to a myriad of former studies which described favorable outcomes in the obese population. [22][23][24] In those studies, thinner patients were older and frailer and had more comorbidities, of which all were associated with poorer outcomes. Moreover, the bleeding incidence was lower among patients with higher BMI undergoing cardiac intervention, 25 To the best of our knowledge, no prior studies were examined whether obesity was related to infection risks in cardiac intervention settings, aka PCI or catheter ablation. ...