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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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Pulmonary embolism in aneurysmal subarachnoid haemorrhage

Lungenembolie in Patienten mit aneurysmatischer Subarachnoidalblutung

Meeting Abstract

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  • presenting/speaker Daniel Dubinski - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Sae-Yeon Won - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Fee Keil - Universitätsklinikum Frankfurt am Main, Klinik für Neuroradiolgie, Frankfurt am Main, Deutschland
  • Bedjan Behmanesh - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Nina Brawanski - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Florian Raimann - Universitätsklinikum Frankfurt am Main, Anästhesiologie, Frankfurt am Main, Deutschland
  • Volker Seifert - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Christian Senft - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland
  • Jürgen Konczalla - Universitätsklinikum Frankfurt am Main, Neurochirurgie, Frankfurt am Main, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocP099

doi: 10.3205/20dgnc386, urn:nbn:de:0183-20dgnc3861

Veröffentlicht: 26. Juni 2020

© 2020 Dubinski 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: Pulmonary embolism (PE) is a dreaded complication with high morbidity and mortality rates. Patients with aneurysmal subarachnoid hemorrhage constitute a critically ill cohort with often strict contraindications to conventional embolism treatment. The aim of the present study is to identify risk factors for pulmonary embolism in this demanding cohort.

Methods: Retrospective analysis of patients with suspected PE and thoracic CT scan included: Age, gender, admission status, treatment modality, the presence of deep vein thrombosis, resuscitation, in-hospital mortality, present anticoagulation, coronary artery disease, diabetes mellitus, smoking status, hypertension, ABO blood type, antidepressants, migraine, hematological analysis, early hydrocephalus, Glasgow outcome scale at 6 months and mRS at 6 months, VP-Shunt at 6 months, cerebral vasospasm, delayed ischemic neurological deficit.

Results: A total of 60 patients had a thoracic CT scan suspected pulmonary embolism. Computer tomography confirmed 25 cases (42%). Smoking (p<0.02) and deep vein thrombosis (p<0.02) were identified as significant risk factors for pulmonary embolism. Patients with PE had a statistically significant lower Karnofsky, and higher extended Glasgow outcome scale values at 6 months than patients without PE (p<0.001, and p<0.02) respectively. The presence of vitamin K antagonists at admission and the development of cerebral vasospasm in the clinical course were protective against PE (p<0.05, and (p<0.02) respectively.

Conclusion: Patients with aneurysmal subarachnoid hemorrhage that present with a history of tobacco use are at an elevated risk for PE which in turn is associated with poor outcome. This cohort should therefore be put under intensified monitoring.