Spontaneous Subarachnoid Hemorrhage: Impact of Demographic, Clinical and Monitoring Data in Patient Outcome

Abstract

Objective The aim was to identify possible factors with impact in outcome in patients admitted with spontaneous Subarachnoid Hemorrhage. Methods This retrospective case-series study included all patients with spontaneous Subarachnoid Hemorrhage admitted to a Neurocritical Unit of a tertiary hospital at intensive care level between the first january 2018 and the 30th june 2019. Primary outcome was defined by Glasgow Outcome Scale. Results Forty-six patients (29 females) were included. Median age was 55.5 years (50.0-63.3). In 41 patients an aneurysm was identified. Age, Fisher scale, hemoglobin level at admission and hydrocephalus were factors with impact on outcome at discharge and 28 days from the event (P<0.05), while the type of intervention had an impact 180 days from the event (P=0.046). No patient submitted to neuroradiology procedure had a bad outcome at six months. At all moments of follow-up, Glasgow Coma scale at admission, Hunt & Hess scale, duration of invasive ventilation and delayed cerebral ischemia had an association with patients' outcome (P<0.05). Conclusions Subarachnoid Hemorrhage related complications were common and associated with worse outcomes, therefore treatment approach should be focused on its avoidance and prompt resolution. Endovascular treatment had better outcomes at six months than surgical intervention.