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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

The BNI scale revisited: predictive capabilities for cerebral infarction and clinical outcome in patients with aneurysmal subarachnoid hemorrhage

Meeting Abstract

  • Nora Dengler - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin, Germany
  • Dominik Diesing - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin, Germany
  • Asita Sarrafzadeh - Klinik für Neurochirurgie, Universitätsklinikum Heidelberg, Germany
  • Stefan Wolf - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin, Germany
  • Peter Vajkoczy - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin, Germany

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.01.09

doi: 10.3205/16dgnc235, urn:nbn:de:0183-16dgnc2358

Veröffentlicht: 8. Juni 2016

© 2016 Dengler 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: In 2012 a new CT grading scale was introduced by the Barrow Neurological Institute (“BNI scale”) to predict angiographic and symptomatic vasospasm in aneurysmal subarachnoid hemorrhage (aSAH). So far, the prognostic value of the BNI scale concerning cerebral infarction and patient outcome has not yet been evaluated.

Method: Consecutive data of 260 patients with aSAH were retrospectively analyzed with respect to angiographic vasospasm, BNI grade, Fisher score, presence of intracerebral hemorrhage (ICH) and intraventricular hemorrhage (IVH) at CT on admission. Cerebral infarction and patient outcome using the modified Rankin score (mRS) were assessed in relation to BNI and Fisher grades.

Results: Patients presenting with more severe BNI grades were older (p=0.024), displayed lower GCS at admission (p≤0.001) and were more often diagnosed with IVH (p≤0.001). Increasing BNI grade was associated with occurrence of new cerebral ischemia (p≤0.001) and with poor patient outcome (p=0.007). In a multivariate analysis, BNI grade and the presence of ICH were significant independent risk factors for the development of new cerebral ischemia (OR: 1.588, CI: 1.196 - 2.138, p=0.002 and OR: 1.540, CI 1.174 - 2.045, p=0.003) and poor patient outcome (OR: 2.753, CI: 1.486 - 5.182, p=0.002 and OR: 3.403, CI: 1.844 - 6.427), while the presence of IVH showed no additional predictive value (OR: 1.323, 0.727 - 2.400, p=0.357 and OR: 1.655, CI 0.911 - 3.001, p=0.098).

Conclusions: In our patient cohort, the BNI grade and the presence of ICH were independent risk factors for new cerebral ischemia and poor patient outcome.