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Factors associated with poor outcome for aneurysmal subarachnoid haemorrhage in a series of 334 patients

Abstract:

Objective This study evaluates care-related sociodemographic, clinical, and imaging factors and influences associated with outcome at discharge in patients with aneurismal subarachnoid haemorrhage. Patients and method Retrospective cohort study in 334 patients treated at Hospital Hermanos Ameijeiras in Havana, Cuba between October 2005 and June 2014. Results Logistic regression analysis determined that the following factors were associated with higher risk of poor outcome: age older than 65 years (OR 3.51, 95% CI 1.79-5.7, P = .031), female sex (OR 2.17, 95% CI 1.22-3.84, P = .0067), systolic hypertension (OR 4.82, 95% CI 2.27-9.8, P = .0001), and hyperglycaemia at admission (OR 3.93, 95% CI 2.10-7.53, P = .0003). Certain complications were also associated with poor prognosis, including respiratory infection (OR 2.73, 95% CI 1.27-5.85, P = .0085), electrolyte disturbances (OR 3.33, 95% CI 1.33-8.28, P = .0073), hydrocephalus (OR 2.21, 95% CI 1.05-4.63, P = .0039), rebleeding (OR 16.50, 95% CI 8.24-41.24, P = .0000), symptomatic vasospasm (OR 19.00, 95% CI 8.86-41.24, P = .0000), cerebral ischaemia (OR 3.82, 95% CI 1.87-7.80, P = .000) and multiplex rebleeding (OR 6.69, 95% CI 1.35-36.39, P = .0019). Grades of III and IV on the World Federation of Neurological Surgeons (OR 2.09, 95% CI 1.12-3.91, P = .0021) and Fisher scales (OR 5.18, 95% CI 2.65-10.29, P = .0008) were also related to poor outcome. Conclusions Outcome of aneurysmal subarachnoid haemorrhage was related to age, sex, clinical status at admission to the stroke unit, imaging findings according to the Fisher scale, blood pressure, glycaemia and such complications as electrolyte disturbances, hydrocephalus, rebleeding, and multiplex rebleeding.