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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

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The Barrow Neurological Institute (BNI) scale as a predictor for delayed ischemic neurological deficits and clinical outcome after aneurysmal subarachnoid hemorrhage – A multicenter analysis from a nationwide patient registry

Meeting Abstract

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  • Marian C. Neidert - Klinik für Neurochirurgie, Universitätsspital Zürich, Switzerland
  • Nicolai Maldaner - Klinik für Neurochirurgie, Universitätsspital Zürich, Switzerland
  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Switzerland
  • Luca Regli - Klinik für Neurochirurgie, Universitätsspital Zürich, Switzerland
  • Jan-Karl Burkhardt - Klinik für Neurochirurgie, Universitätsspital Zürich, Switzerland
  • Swiss SOS study group

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.01.08

doi: 10.3205/16dgnc234, urn:nbn:de:0183-16dgnc2346

Veröffentlicht: 8. Juni 2016

© 2016 Neidert et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: To analyze the influence of the Barrow Neurological Institute (BNI) scale, a semi-quantitative scale measuring maximal cisternal blood thickness on axial computed tomography, on delayed ischemic neurological deficits (DIND) and modified Rankin scale (mRS) at 1 year follow-up (1yFU) in patients with aneurysmal subarachnoid hemorrhage (aSAH).

Method: All patient data was obtained from the Swiss nationwide multicenter registry database of aSAH. In 796 patients, BNI scale, mRS at 1yFU, DIND and demographic data were available for descriptive and univariate statistics. MRS was dichotomized in favorable (0-2) and unfavorable (3-6) outcome for this analysis.

Results: 222 patients (27.9%) developed symptomatic vasospasm. DIND risk for patients with a BNI scale of 1 was 5.7%, BNI 2: 14%, BNI 3: 23.1%, BNI 4: 33.7% and BNI 5: 41%, respectively (p<0.0001). Odds ratios for DIND in patients with high grade BNI (4-5) was 2.5 (95% CI 1.78-3.41) compared to 0.4 (95% CI 0.29-0.56) in low-grade BNI (1-3). BNI scale was also associated with clinical outcome [mRS] at 1yFU (p<0.0001) and patients with a BNI scale of 5 had an odds ratio of 2.4 (95% CI 1.69-3.45) for unfavorable outcome.

Conclusions: 1) In a firstly described external validation analysis from a multicenter nationwide patient registry we confirmed that patients with a higher BNI scale showed a significantly higher risk for DIND. 2) The BNI scale was also a predictor for mRS at 1yFU and patients with a higher BNI had a significantly worse outcome.