Artikel
Neurocritical care complications and interventions influence the outcome after aneurysmal subarachnoid haemorrhage
Intensivmedizinische Komplikationen und Interventionen beeinflussen das Outcome nach aneurysmatischer Subarachnoidalblutung
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Autoren
Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: This observational study shows the influence of complications and interventions of neurocritical care units on the outcome after aneurysmal subarachnoid hemorrhage (SAH).
Methods: We analyzed 203 cases of treatment of ruptured intracranial aneurysms which were classified regarding the one year outcome according to the modified Rankin Scale (mRS). We reviewed the data with reference to the occurrence of typical complications and interventions on neurocritical care units.
Results: Sepsis (odds ratio 14.67/6.08, p=0.037/0.033), hydrocephalus (odds ratio 3.71/6.46; p=0.010/0.00095) and decompression (odds ratio 21.77/6.17; p<0.0001/p=0.013) were significant predictors for poor outcome and death after one year besides 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 binary logistic regression model. Tracheostomy (odds ratio 0.09; p=0.0016) and shunting procedure (odds ratio 0.18; p=0.025) were associated with a preventive effect regarding death after one year. WFNS grade (odds ratio 2.23), hydrocephalus (odds ratio 3.49) and decompression (odds ratio 4.45) had a significant impact on the occurrence of pneumonia. Patients with higher WFNS grade, pneumonia, sepsis, shunt procedure and decompression were more likely to get tracheostomized.
Conclusion: We revealed significant factors on intensive care units which influence the outcome after SAH as well as the occurrence of pneumonia and tracheostomy. Tracheostomy and shunting procedure had a preventive effect on the occurrence of death after one year.