Predictors of 1-year outcome after coiling for poor-grade subarachnoid aneurysmal hemorrhage.
Neurocrit Care
; 7(1): 18-26, 2007.
Article
en En
| MEDLINE
| ID: mdl-17657653
ABSTRACT
OBJECTIVE:
To describe features in patients admitted to the intensive care unit (ICU) for poor-grade aneurysmal subarachnoid hemorrhage (SAH) and to identify predictors of 12-month outcome.METHODS:
We conducted a controlled observational study of 51 consecutive patients treated with endovascular coiling within 96 h of rupture for poor-grade aneurysmal SAH (20 men and 31 women, age 54 +/- 12 years). We recorded co-morbidities; initial severity; aneurysm location; occurrence of acute hydrocephalus, initial seizures, and/or neurogenic lung edema; troponin values, Fisher grade; computed tomography (CT) findings; treatment intensity; and occurrence of vasospasm. The brain injury marker S100B was assayed daily over the first 8 days. Glasgow Outcome Scores (GOS) were recorded at ICU discharge, at 6 and 12 months. The main outcome criterion was the 1-year GOS score, which we used to classify patients as having a poor outcome (GOS 1-3) or a good outcome (GOS 4-5).RESULTS:
Overall, clinical status after 1 year was very good (GOS 5) in 41% of patients and good (GOS 4) in 16%. Neither baseline characteristics nor interventions differed significantly between patients with good outcome (GOS 4-5) and those with poor outcome (GOS 1-3). Persistent intracranial pressure elevation and higher mean 8-day S100B value significantly and independently predicted the 1-year GOS outcome (P = 0.008 and P = 0.001, respectively).CONCLUSIONS:
Patients in poor clinical condition after SAH have more than a 5050 chance of a favorable outcome after 1 year. High mean 8-day S100B value and persistent intracranial hypertension predict a poor outcome (GOS 1-3) after 1 year.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hemorragia Subaracnoidea
/
Cuidados Críticos
/
Embolización Terapéutica
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neurocrit Care
Asunto de la revista:
NEUROLOGIA
/
TERAPIA INTENSIVA
Año:
2007
Tipo del documento:
Article
País de afiliación:
Francia