Artikel
Prospective evaluation of In – vitro platelet function analysis in acute aneurysmal subarachnoid hemorrhage – a multicenter study
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Veröffentlicht: | 18. Juni 2018 |
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Objective: Platelet function may play an essential role in the evolution of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH). Thus impaired platelet function induced e.g. by intake of Acetylsalicylic acid (ASA) might positively influence the rate of DCI. The aim of this study was to prospectively analyse the rate of DCI in patients with in – vitro impairment of platelet function.
Methods: A prospective observational study was carried out starting in June 2015. Six German neurosurgical centers took part. Platelet function was assessed using the platelet function analyser test (PFA) on defined time points (before the aneurysm repair, after the aneurysm repair, during the phase of the early brain injury (day 1 -3), during the later phase of the disease. Baseline parameters were collected. DCI was analysed. Outcome was measured using the mGOS.
Results: This is an intermediate analysis of the data. So far 117 patients have been included. Median age was 54.6 years. Mean WFNS score was 2.6, mean modified Fisher score was 3.2. Interventional coiling was the predominant aneurysm closure modality (64%). The overall rate of DCI was 33.3%. The main result of the study is that there was a strong association between a regular platelet function and the occurrence of DCI (p=0.0005, RR 2.8).
Conclusion: Our results suggest that impaired in-vitro platelet function might have a positive influence on the occurrence of DCI after acute aneurysmal SAH. The data will be evaluated after inclusion of 200 patients. Furthermore, these results warrant further research on focal platelet activation during cerebral vasospasm.