Clinical condition of 120 patients alive at 3 years after poor-grade aneurysmal subarachnoid hemorrhage.
Acta Neurochir (Wien)
; 163(4): 1153-1166, 2021 04.
Article
em En
| MEDLINE
| ID: mdl-33629124
ABSTRACT
BACKGROUND:
To study the clinical condition of poor-grade aneurysmal subarachnoid hemorrhage (aSAH) patients alive at 3 years after neurointensive care.METHODS:
Of the 769 consecutive aSAH patients from a defined population (2005-2015), 269 (35%) were in poor condition on admission 145 (54%) with H&H 4 and 124 (46%) with H&H 5. Their clinical lifelines were re-constructed from the Kuopio Intracranial Aneurysm Database and Finnish nationwide registries. Of the 269 patients, 155 (58%) were alive at 14 days, 125 (46%) at 12 months, and 120 (45%) at 3 years.RESULTS:
The 120 H&H 4-5 patients alive at 3 years form the final study population. On admission, 73% had H&H 4 but only 27% H&H 5, 59% intracerebral hematoma (ICH; median 22 cm3), and 26% intraventricular blood clot (IVH). The outcome was favorable (mRS 0-1) in 45% (54 patients ICH 44%; IVH clot 31%; shunt 46%), moderate (mRS 2-3) in 30% (36 patients ICH 64%; IVH clot 19%; shunt 42%), and unfavorable (mRS 4-5) in 25% (30 patients ICH 80%; IVH clot 23%; shunt 50%). A total of 46% carried a ventriculoperitoneal shunt. ICH volume was a significant predictor of mRS at 3 years.CONCLUSIONS:
Of poor-grade aSAH patients, 45% were alive at 3 years, even 27% of those extending to pain (H&H 5). Of the survivors, 75% were at least in moderate condition, while only 2.6% ended in hospice care. Consequently, we propose non-selected admission to neurointensive care (1) for a possibility of moderate outcome, and (2), in case of brain death, possibly improved organ donation rates.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Hemorragia Subaracnóidea
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Aneurisma Intracraniano
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Sistema de Registros
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article