BACKGROUND: Mortality rates of up to 40% in the early phase following an aneurysmal subarachnoid haemorrhage (SAH) indicate that the overall case-fatality rate is predominantly influenced by the initial phase of the disease. This analysis investigates the in-hospital causes of death (CODs) within 30 days of admission in patients suffering from a SAH. METHODS: Of the 591 consecutive patients with SAHs from ruptured cerebral aneurysms, 85 patients who died within 30 days after admission were analysed. The various CODs were classified as cerebral or non-cerebral events. A Kaplan-Meier survival analysis was performed for the cerebral and non-cerebral CODs to identify the specific chronology of occurrence. RESULTS: The median cumulative fatality was 4 days. A cerebral oedema as a result of initial brain damage after ictus was the predominant COD (n=24, 28.2%; median cumulative fatality, 1 day; IQR, 1-4 days; SEM, 0.680), followed by cerebral infarction caused by delayed cerebral ischaemia (DCI) (n=13, 15.3%; median cumulative fatality, 9 days; IQR, 4-13 days; SEM, 1.379). Renal failure was the predominant non-cerebral COD before cardiac and pulmonary complications (n=6, 7.1%). CONCLUSIONS: Mortalities after SAHs predominantly occur within the first days after ictus. The dominant cerebral cause of death is early initial cerebral oedema, followed by DCI.
BACKGROUND: Mortality rates of up to 40% in the early phase following an aneurysmal subarachnoid haemorrhage (SAH) indicate that the overall case-fatality rate is predominantly influenced by the initial phase of the disease. This analysis investigates the in-hospital causes of death (CODs) within 30 days of admission in patients suffering from a SAH. METHODS: Of the 591 consecutive patients with SAHs from ruptured cerebral aneurysms, 85 patients who died within 30 days after admission were analysed. The various CODs were classified as cerebral or non-cerebral events. A Kaplan-Meier survival analysis was performed for the cerebral and non-cerebral CODs to identify the specific chronology of occurrence. RESULTS: The median cumulative fatality was 4 days. A cerebral oedema as a result of initial brain damage after ictus was the predominant COD (n=24, 28.2%; median cumulative fatality, 1 day; IQR, 1-4 days; SEM, 0.680), followed by cerebral infarction caused by delayed cerebral ischaemia (DCI) (n=13, 15.3%; median cumulative fatality, 9 days; IQR, 4-13 days; SEM, 1.379). Renal failure was the predominant non-cerebral COD before cardiac and pulmonary complications (n=6, 7.1%). CONCLUSIONS: Mortalities after SAHs predominantly occur within the first days after ictus. The dominant cerebral cause of death is early initial cerebral oedema, followed by DCI.
Authors: Jasper H van Lieshout; Maxine Dibué-Adjei; Jan F Cornelius; Philipp J Slotty; Toni Schneider; Tanja Restin; Hieronymus D Boogaarts; Hans-Jakob Steiger; Athanasios K Petridis; Marcel A Kamp Journal: Neurosurg Rev Date: 2017-02-18 Impact factor: 3.042
Authors: Akshitkumar M Mistry; Jordan A Magarik; Michael J Feldman; Li Wang; Christopher J Lindsell; Matthew R Fusco; Rohan V Chitale; Gordon R Bernard; Wesley H Self; Todd W Rice; Christopher G Hughes; Eva A Mistry; Matthew W Semler Journal: Stroke Vasc Interv Neurol Date: 2022-05-08
Authors: Athanasios K Petridis; Marcel A Kamp; Jan F Cornelius; Thomas Beez; Kerim Beseoglu; Bernd Turowski; Hans-Jakob Steiger Journal: Dtsch Arztebl Int Date: 2017-03-31 Impact factor: 5.594
Authors: Sebastian Arts; Erik J van Lindert; Rene Aquarius; Ronald H M A Bartels; Hieronymus D Boogaarts Journal: Acta Neurochir (Wien) Date: 2021-01-02 Impact factor: 2.216
Authors: Benjamin W Y Lo; Hitoshi Fukuda; Yusuke Nishimura; R Loch Macdonald; Forough Farrokhyar; Lehana Thabane; Mitchell A H Levine Journal: Surg Neurol Int Date: 2015-08-11