Abstract TP141: Impacts Of Dysnatremia On Outcomes In Aneurysmal Subarachnoid Hemorrhage

Autor: Alexandra Helliwell, Ryan Snow, Christoph Stretz, Nicholas S Potter, Linda C Wendell, Bradford Thompson, Michael Reznik, Karen L Furie, Ali Mahta
Rok vydání: 2022
Předmět:
Zdroj: Stroke. 53
ISSN: 1524-4628
0039-2499
DOI: 10.1161/str.53.suppl_1.tp141
Popis: Disturbances in serum sodium levels are common following aneurysmal subarachnoid hemorrhage (aSAH) and may lead to increased morbidity, mortality, and poor functional outcomes. This study aims to examine the relationship between abnormal sodium levels following aSAH and patient outcomes. A retrospective cohort study of consecutive patients with aSAH who were admitted to an academic referral center between 2015 and 2021 was performed. Dysnatremia was categorized as either mild or moderate-severe and patients were sorted accordingly. Multivariable logistic regression was used to test the association of any dysnatremia and outcomes, including modified Rankin Scale (mRS) at 3 months after discharge, vasospasm (based on transcranial Doppler criteria), delayed cerebral ischemia (DCI) and refractory hydrocephalus requiring ventriculoperitoneal shunt. Multiple linear regression was used to test the association of hospital length of stay and dysnatremia (categorical variables). We included 320 patients (mean age 57.8 years (SD 14.3), 61% female, 70% white). Hyponatremia was seen in 58% for a median of 3 days [IQR 1-6], with moderate-severe hyponatremia occurring in 5%. Hypernatremia was observed in 49% for a median of 5 days [IQR 2-8], 56% of whom had moderate-severe hypernatremia. Of 156 hypernatremic patients, 80% were treated with hypertonic saline for cerebral edema. Hypernatremia was independently associated with a higher odds of vasospasm (OR 1.75, 95% CI 1.02-303, p =0.04) when adjusted for Hunt and Hess grades, cerebral edema and modified Fisher scales. There was no independent association between any dysnatremia and mRS, DCI or refractory hydrocephalus. Hospital length of stay was longer in patients with hypernatremia (8.11 more hospital days, 95% CI 5.4-10.8; p
Databáze: OpenAIRE
Externí odkaz: