| Autor: |
Ana Pereira, Paola Sanchez-Peña, Alessandra Biondi, Nader Sourour, Anne Boch, Chantal Colonne, Lise Lejean, Lamine Abdennour |
| Předmět: |
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| Zdroj: |
Neurocritical Care; Aug2007, Vol. 7 Issue 1, p18-26, 9p |
| Abstrakt: |
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 50:50 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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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