Alexander Hammer1, Frank Erbguth2, Matthias Hohenhaus3, Christian M Hammer4, Hannes Lücking5, Markus Gesslein6, Monika Killer-Oberpfalzer7, Hans-Herbert Steiner8, Hendrik Janssen9. 1. Department of Neurosurgery, Paracelsus Medical University, Breslauer Straße 201, 90471, Bavaria, Nuremberg, Germany. alexander.hammer@klinikum-nuernberg.de. 2. Department of Neurology, Paracelsus Medical University, Breslauer Str. 201, 90471, Bavaria, Nuremberg, Germany. 3. Department of Anaesthesiology, Paracelsus Medical University, Breslauer Str. 201, 90471, Bavaria, Nuremberg, Germany. 4. Department of Anatomy 2, University of Erlangen-Nuremberg, Universitätsstraße 19, 91054, Bavaria, Erlangen, Germany. 5. Department of Neuroradiology, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany. 6. Department of Orthopaedics and Traumatology, Paracelsus Medical University, Breslauer Str. 201, 90471, Bavaria, Nuremberg, Germany. 7. Neurology/Research Institute of Neurointervention, Paracelsus Medical University, Ignaz Harrer Str. 79, Salzburg, Austria. 8. Department of Neurosurgery, Paracelsus Medical University, Breslauer Straße 201, 90471, Bavaria, Nuremberg, Germany. 9. Department of Neuroradiology, Ingolstadt General Hospital, Krumenauerstraße 25, 85049, Bavaria, Ingolstadt, Germany.
Abstract
BACKGROUND: This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH). METHODS: We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units. RESULTS: Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside "World Federation of Neurosurgical Societies" (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model). CONCLUSIONS: In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.
BACKGROUND: This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH). METHODS: We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units. RESULTS: Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside "World Federation of Neurosurgical Societies" (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model). CONCLUSIONS: In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.
Authors: Susan L Bratton; Randall M Chestnut; Jamshid Ghajar; Flora F McConnell Hammond; Odette A Harris; Roger Hartl; Geoffrey T Manley; Andrew Nemecek; David W Newell; Guy Rosenthal; Joost Schouten; Lori Shutter; Shelly D Timmons; Jamie S Ullman; Walter Videtta; Jack E Wilberger; David W Wright Journal: J Neurotrauma Date: 2007 Impact factor: 5.269
Authors: Hormuzdiyar H Dasenbrock; Robert F Rudy; Pui Man Rosalind Lai; Timothy R Smith; Kai U Frerichs; William B Gormley; M Ali Aziz-Sultan; Rose Du Journal: J Neurosurg Date: 2017-10-27 Impact factor: 5.115