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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Aspirin reduces the risk for delayed cerebral ischemia due to subarachnoid hemorrhage

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  • Marvin Darkwah Oppong - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Annika Herten - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Daniela Pierscianek - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Thiemo Florin Dinger - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Nicolai El Hindy - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV087

doi: 10.3205/18dgnc088, urn:nbn:de:0183-18dgnc0886

Published: June 18, 2018

© 2018 Darkwah Oppong et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Delayed cerebral ischemia (DCI) has a strong impact on the outcome of patients with aneurysmal subarachnoid hemorrhage (SAH). There have been smaller trials suggesting that aspirin might be useful against DCI. However, it carries the risk of bleeding complications. We aimed to analyze the benefit/risk profile of aspirin administration in SAH patients.

Methods: Out of an institutional observational cohort with 995 SAH patients treated between January 2003 and December 2016, the individuals with post-coiling aspirin administration were compared to the control group (coiling without aspirin) with regard to the occurrence of DCI and bleeding complications in the follow-up computed tomography scans, as well as a favorable outcome after SAH (defined as modified Rankin scale<3).

Results: Of 328 patients with post-treatment aspirin, DCI was observed in 52 cases (15.9% vs 26.9%% (68/253) in the non-aspirin group). Aspirin administration independently reduced the risk of DCI (p=0.004, OR=0.512 in the multivariate analysis including the patients’ age, initial WFNS and Fisher grades, and the occurrence of vasospasm requiring spasmolysis). The rate of bleeding complications was higher in the aspirin group (8.8% vs. 4.0%, p=0.02; OR=2.345). Finally, aspirin use was independently associated with a favorable outcome at 6 months after SAH (p=0.03, OR=1.739 after adjusting for age and initial WFNS grade).

Conclusion: Although associated with more frequent bleeding complications, aspirin use after aneurysm s treatment may reduce the rate of DCI and, therefore, improve the functional outcome of SAH. Our data underline the need for a prospective randomized trial for the evaluation of aspirin effect in SAH.