Prospective analysis of cerebral edema admission and clinical outcome in ruptured intracranial aneurysm.

医学 格拉斯哥昏迷指数 前瞻性队列研究 改良兰金量表 单变量分析 蛛网膜下腔出血 格拉斯哥结局量表 内科学 多元分析 麻醉 缺血 缺血性中风
作者
Dan Zimelewicz Oberman,Ní­collas Nunes Rabelo,Leonardo Zumerkorn Pipek,João Paulo Mota Telles,Natalia Camargo Barbat,Antônio Carlos Samaia da Silva Coelho,Márcia Harumy Yoshikawa,Guilherme Bittencourt Barbosa,Manoel Jacobsen Teixeira,Eberval Gadelha Figueiredo
出处
期刊:Turkish Neurosurgery [Turkish Neurosurgical Society]
标识
DOI:10.5137/1019-5149.jtn.41935-22.2
摘要

To evaluate the association between global cerebral edema (GCE) after subarachnoid hemorrhage (SAH) and its impact on functional outcome evaluated by the modified Rankin scale (mRS).This is a prospective cohort study with patients who were admitted to the hospital due to SAH. During the period from January 2018 to November 2019, 107 patients with intracranial aneurysms were enrolled. Using univariate and multivariate analysis, we sought to identify predictors and evaluated the impact of GCE on outcome after 6 months using the mRS.GCE was present in 54 (50.5%) patients, of which 27 (25.2%) were mild, 20 (18.7%) moderate and 7 (6.5%) were severe. Univariate analysis identified high Hunt-Hess and Glasgow coma scale on clinical admission as predictors factors of GCE (p < 0.05), and higher modified Fisher scale as a radiological predictor of Glasgow coma scale (p < 0.05). Thirty-three (30.8%) patients were deceased at 6 months. Death or severe disability were predicted by higher age, poor clinical scale on admission and severe GCE (p < 0.05).GCE on admission is independently associated with poor clinical outcomes at discharge, and six months after SAH. Given its strong association with poor clinical grade on admission, GCE should be considered a straightforward and radiological important marker of early brain injury, with ominous implications.

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