Is There an Influence of Routine Daily Transcranial Doppler Examination on Clinical Outcome in Patients After Aneurysmal Subarachnoid Hemorrhage?

Autor: Thomas Kirschning, Marcel Seiz-Rosenhagen, Holger Wenz, Peter Schmiedek, Aldemar Andres Hegewald, Gregory Ehrlich, Christoph Groden, Johann Scharf
Rok vydání: 2016
Předmět:
Male
Ultrasonography
Doppler
Transcranial
Comorbidity
law.invention
Postoperative Complications
0302 clinical medicine
law
Modified Rankin Scale
Germany
Vasospasm
Intracranial
030212 general & internal medicine
Aged
80 and over
Incidence
Glasgow Outcome Scale
Vasospasm
Middle Aged
Intensive care unit
Causality
Survival Rate
Treatment Outcome
cardiovascular system
Female
Radiology
Cohort study
Adult
medicine.medical_specialty
Subarachnoid hemorrhage
Risk Assessment
Sensitivity and Specificity
03 medical and health sciences
Age Distribution
Internal medicine
medicine
Humans
Sex Distribution
Watchful Waiting
Survival rate
Aged
Postoperative Care
Diagnostic Tests
Routine
business.industry
Reproducibility of Results
Subarachnoid Hemorrhage
medicine.disease
Transcranial Doppler
Patient Outcome Assessment
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
Zdroj: World Neurosurgery. 88:214-221
ISSN: 1878-8750
DOI: 10.1016/j.wneu.2015.11.091
Popis: Background Transcranial Doppler (TCD) is widely used as a daily routine method to detect vasospasm in patients after aneurysmal subarachnoid hemorrhage (aSAH); however, there are only limited data about the real benefit of this examination. Therefore, the clinical outcome of 2 cohorts with and without daily TCD after aSAH was assessed. Methods All patients included in this study received a standardized diagnostic and treatment protocol. Fifty patients admitted with aSAH from January 2013 to December 2013 received daily TCD measurements; 39 patients admitted from January 2014 to September 2014 received no TCD measurements. Data on clinical grade (Hunt and Hess grade), severity of bleeding (Barrow Neurological Institute grade), localization of aneurysm, and angiographic or clinically relevant vasospasm were collected prospectively. The Glasgow Outcome Scale, modified Rankin Scale, and the National Institute of Health Stroke Scale were used as clinical outcome parameters. Results Patient baseline characteristics and clinical data were comparable; treatment modality of the aneurysm was not different between the groups ( P = 0.7756). No significant difference between the Hunt and Hess grade ( P = 0.818) and the Barrow Neurological Institute grade ( P = 0.1551) was observed. There was also no significance concerning the incidence of angiographic or clinically relevant vasospasm between both groups ( P = 0.5842 and P = 0.7933). Glasgow Outcome Scale, mRS, and National Institute of Health Stroke Scale as the primary outcome parameters showed no significant difference in morbidity and mortality between both groups (mortality P = 0.8544). Conclusions With the limitation of an explorative cohort study, the results indicate that routine TCD studies do not improve the overall outcome of patients after aSAH.
Databáze: OpenAIRE
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