Neurocritical care complications and interventions influence the outcome in aneurysmal subarachnoid hemorrhage

• Main Authors: Alexander Hammer, Frank Erbguth, Matthias Hohenhaus, Christian M. Hammer, Hannes Lücking, Markus Gesslein, Monika Killer-Oberpfalzer, Hans-Herbert Steiner, Hendrik Janssen
• Format: Article
• Language: English
• Published: BMC 2021-01-01
• Series: BMC Neurology
• Subjects: Intracranial aneurysm; Subarachnoid hemorrhage; Vascular disorders; Outcome; Neurocritical care; Decompressive craniectomy
• Online Access: https://doi.org/10.1186/s12883-021-02054-6

Abstract Background This observational study was performed to show the impact of complications and interventions during neurocritical care on the outcome after aneurysmal subarachnoid hemorrhage (SAH). Methods We analyzed 203 cases treated for ruptured intracranial aneurysms, which were classified regarding clinical outcome after one year according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions in neurocritical care units. Results Decompressive craniectomy (odds ratio 21.77 / 6.17 ; p < 0.0001 / p = 0.013), sepsis (odds ratio 14.67 / 6.08 ; p = 0.037 / 0.033) and hydrocephalus (odds ratio 3.71 / 6.46 ; p = 0.010 / 0.00095) were significant predictors for poor outcome and death after one year beside “World Federation of Neurosurgical Societies” (WFNS) grade (odds ratio 3.86 / 4.67 ; p < 0.0001 / p < 0.0001) and age (odds ratio 1.06 / 1.10 ; p = 0.0030 / p < 0.0001) in our multivariate analysis (binary logistic regression model). Conclusions In summary, decompressive craniectomy, sepsis and hydrocephalus significantly influence the outcome and occurrence of death after aneurysmal SAH.