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J Neurointerv Surg ; 7(11): 855-60, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25200246

RESUMO

OBJECTIVE: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating illness with nationwide mortality rates reaching almost 50% within the first 30 days. A study was undertaken to evaluate how treatment modality, physical findings, and geo-demography contribute to the outcome of these cases, including complications and disposition status. METHODS: All cases of aSAH in the fiscal year of 2012 (July 2011-June 2012) at the Medical University of South Carolina and Palmetto Health Richland were studied. These healthcare facilities represent 88.5% of aneurysm treatment in the state of South Carolina. Information including aneurysm properties, Hunt-Hess grade, Fisher grade, and symptoms occurring at and after admission were analyzed. RESULTS: 131 patients (94 women and 37 men) with aSAH were treated. 92.4% of cases were treated endovascularly, with more than a third of all cases using balloon-assisted coiling. Hypertension, tobacco use, and hyperlipidemia were the most prevalent comorbidities. Headache, followed by hydrocephalus, motor disturbance, and nausea/vomiting were the most common presenting symptoms. The most common adverse event occurring after hospital admission was acute respiratory failure followed by urinary tract infection, hydrocephalus, and vasospasm. 42.0% were discharged home and nine patients (6.9%) died during hospitalization. CONCLUSIONS: Previously established risk factors such as hypertension and smoking were identified as the most prevalent comorbidities, with disparity between subgroups, particularly women and African Americans. Endovascular treatment was the primary modality of treatment. Mortality rates were lower than previously reported.


Assuntos
Avaliação de Resultados em Cuidados de Saúde , Hemorragia Subaracnóidea , Negro ou Afro-Americano/etnologia , Aneurisma Roto/complicações , Aneurisma Roto/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Fatores Socioeconômicos , South Carolina/epidemiologia , Hemorragia Subaracnóidea/epidemiologia , Hemorragia Subaracnóidea/mortalidade , Hemorragia Subaracnóidea/patologia , Hemorragia Subaracnóidea/terapia
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