Artikel
Validation and age dependency of Subarachnoid Hemorrhage Early Brain Edema Score (SEBES)
Validierung und Altersabhängigkeit des Subarachnoid Hemorrhage Early Brain Edema Scores (SEBES)
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Autoren
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Michael Eibach
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Sae-Yeon Won
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Sepide Kashefiolasl
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Nazife Dinc
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Markus Bruder
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Eva Herrmann
- Institut für Biostatistik und Mathematische Modellierung, Frankfurt am Main, Deutschland
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Volker Seifert
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
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Jürgen Konczalla
- Universitätsklinikum Frankfurt, Neurochirurgie, Frankfurt am Main, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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| Veröffentlicht mit Erratum: | 16. Mai 2019 |
Gliederung
Text
Objective: Early brain injury (EBI) after subarachnoid hemorrhage (SAH) is associated with a poor prognosis. A key factor for EBI is cerebral edema. The Subarachnoid hemorrhage Early Brain Edema Score (SEBES) is a semiquantitative score to measure cerebral edema in cranial CT.1
Until now, only one publication could show that SEBES predicts the outcome in patients with SAH1 and it is unclear if SEBES is suitable for all age groups. Therefore, we validated SEBES from another SAH-cohort and investigated a possible age dependency.
Methods: We used our prospectively collected database and analysed retrospectively all patients with a non-traumatic SAH, who were admitted to our hospital from January 2011 to February 2017 (n=668). We included only patients with an initial CT within 12 hours after ictus. We measured cerebral edema in the initial CT with SEBES. 0,1 and 2 points indicated a weak cerebral edema (low-grade SEBES), 3 and 4 points indicated a severe cerebral edema (high-grade SEBES).1 Outcome six months after SAH was measured with a modified Rankin Scale (mRS).
Results: 300 patients were analysed. Patients with low-grade SEBES had a significantly lower H&H and WFNS grade at admission than patients with high-grade SEBES (p<0.00001). However, patients with high-grade SEBES had delayed cerebral ischemia more often (p<0.00001) and had a higher mRS six months after ictus (3.1 vs 1.9, p<0.00001) than patients with low-grade SEBES.
SEBES showed an age dependency. Patients under 60 years had a significantly higher mean SEBES than patients over 60 years (p<0.00001). Nonetheless, within the age groups under 60 years and 60–69 years the SEBES can predict the outcome. However, the SEBES cannot predict the outcome in patients aged 70 years or older.
Conclusion: SEBES is a reliable tool to easily measure cerebral edema in patients with SAH and to predict the outcome after SAH. Our results correspond with the first publication of SEBES. However, SEBES is age-dependent and correlates with the outcome only in patients under 70 years. Therefore, SEBES should be used only in patients with SAH who are younger than 70 years.
References
- 1.
- Ahn SH, Savarraj JP, Pervez M, et al. The Subarachnoid Hemorrhage Early Brain Edema Score Predicts Delayed Cerebral Ischemia and Clinical Outcomes. Neurosurgery. 2018;83(1):137-45. DOI: 10.1093/neuros/nyx364
Erratum
The abstract text has been corrected. In results, a sentence has been deleted, in the conclusion a half-sentence.
