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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Influence of cardiopulmonary resuscitation on the early outcome of patients with subarachnoid hemorrhage Hunt and Hess grade 5

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  • Sami Ridwan - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
  • Konstantinos Gousias - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
  • Christian Blume - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
  • Hartmut Vatter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn
  • Rudolf A. Kristof - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.18.08

doi: 10.3205/14dgnc385, urn:nbn:de:0183-14dgnc3858

Published: May 13, 2014

© 2014 Ridwan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Primary objective was to assess the influence of cardiopulmonary resuscitation (CPR) on the outcome of patients with subarachnoid hemorrhage Hunt and Hess grade 5 (SAH H&H 5). A secondary objective was to assess the influence of SAH H&H 5 on CPR outcome

Method: A successive series of patients with SAH H&H 5 with and without CPR, as well as patients with CPR for other reasons, were retrospectively identified at one single institution during a period of 10 years. Data were extracted from the patients' records. The outcome of CPR and the outcome at hospital discharge were assessed by the Glasgow Outcome Score (GOS) and the modified Rankin Scale (mRS)

Results: Out of 84 patients with SAH H&H 5 (median age 55 years, 61 females), 21 (median age 50 years, 15 females) had undergone CPR. Another 81 patients with other diagnoses (median age 71 years, 34 females) have undergone CPR during the same study period. The mortality of patients with SAH H&H 5 and CPR was 85% with, and 68% without CPR (p=0,158). At discharge the median GOS and median mRS of patients with SAH H&H 5 and CPR was 1 and 6, and 1 and 6 without CPR (p=0,295). The mortality of patients with CPR and SAH H&H 5 was 85%, and 80% without SAH H&H 5 (p=0,757). At discharge the median GOS and median mRS of CPR patients with SAH H&H 5 was 1 and 6, and 1 and 6 without SAH H&H 5 (p=0,839). The effect of gender, age, localization of the aneurysm (anterior vs. posterior circulation), and therapy performed (clipping/coiling performed or not), on the early outcome of patients with SAH H&H 5 was also assessed. Gender and age did not significantly influence the early GOS (p=0,149 and p=0,076, respectively) and mRS (p=0,106 and p=0,545, respectively). A better outcome was found in patients with clipped/coiled aneurysms (GOS and mRS, p < 0,001 each), as well as in patients with aneurysms of the posterior circulation for the GOS (p= 0,004)

Conclusions: As reflected by GOS and mRS, there was no significant influence of CPR upon the early outcome of patients with SAH H&H 5. However, other factors like aneurysm localisation and treatment performed, may influence the early outcome of these patients