Turkish Neurosurgery
Predictors of Outcome in Aneurysmal Subarachnoid Hemorrhage: A Tertiary Center Experience
Merve Ergenç1, Ayten Saraçoğlu2, Yaşar Bayri3, İsmail Cinel4, Beliz Bilgili2
1Kocaeli Derince Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon, Kocaeli,
2Marmara Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon, İstanbul,
3Marmara Üniversitesi Tıp Fakültesi, Beyin ve Sinir Cerrahisi, İstanbul,
4Acıbadem Hospital Groups, Anesteziyoloji ve Reanimasyon, İstanbul,
DOI: 10.5137/1019-5149.JTN.43486-23.5

Aim:To determine the risk factors affecting the mortality rate and outcomes of patients with subarachnoid hemorrhage (SAH).Material and Methods:The records of patients who underwent aneurysm treatment and intensive care unit (ICU) follow-up in our hospital between 2013-2021 were reviewed retrospectively. Demographics of the patients, aneurysm characteristics, complications in the ICU, the Hunt Hess score, Glasgow Coma Scale (GCS), Acute Physiologic Assessment and Chronic Health Evaluation II score (APACHE II), sepsis status, and mechanical ventilation (MV) needed during ICU admission were collected. The generalized linear mixed modeling method was used to determine independent risk factors affecting mortalityResults:The records of 91 patients who met the inclusion criteria were analyzed. The age of the patients ranged from 21 to 86 years, and the female-to-male ratio was 6 / 7, with a mean age of 49.9 ± 13.06 years. The aneurysm treatment modality was surgical in 79 patients (86.8%) and endovascular in 12 patients 13.2%. The length of the ICU stay was mean 10.96 ± 13.66 days. While 64.8% (n = 59) of the patients were discharged, 7.7% (n = 7) were referred to palliative care units, and 25% (n = 25) died. A one-unit increase in the APACHE II score was determined to increase the risk of vasospasm 1.154 times (p < 0.001). Analysis showed that a one-day increase in the MV day increased the mortality risk 1.838 times (p < 0.001), and vasospasm increased the mortality risk 32.151 times (p = 0.004)Conclusion:The length of hospital stay, the day of MV, and the presence of vasospasm were determined as independent risk factors affecting mortality. Early diagnosis and rapid treatment of vasospasm, which increases mortality during ICU follow-up, positively impact patient outcomes

Corresponding author : Merve Ergenç