Article
The association of hypothyroidism and aneurysmal subarachnoid hemorrhage – Identification of a new risk factor for SAH?
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Authors
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Marius Mader
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Thomas Sauvigny
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Georg Rosenberger
- Universitätsklinikum Hamburg-Eppendorf, Institut für Humangenetik, Hamburg, Deutschland
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Franz Lennard Ricklefs
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Manfred Westphal
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Jan Regelsberger
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Nils Ole Schmidt
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
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Patrick Czorlich
- Universitätsklinikum Hamburg-Eppendorf, Klinik für Neurochirurgie, Hamburg, Deutschland
| Published: | June 18, 2018 |
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Outline
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Objective: Thyroid dysfunction has been associated with aortic aneurysms and vascular dysfunction, however, there is limited data available on the prevalence of hypothyroidism in patients with aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that the prevalence of hypothyroidism at admission in SAH patients is more frequent than in the general population.
Methods: Patients with proven aneurysmal SAH admitted to our institution between 10/2010 and 09/2017 were reviewed. The prevalence of hypothyroidism documented in the medical history or proven in the blood analysis at admission in this cohort was compared to epidemiological data provided by the Robert Koch Institute based on approximately 15000 subjects. From this data, we estimated a maximum prevalence of hypothyroidism in the overall population in consideration of age, sex and geographical region. Clinical characteristics were compared between patients with and without thyroid dysfunction. Statistical analyses (chi-square-test, Mann-Whitney-U-test) were calculated. Probability values of p
Results: In total, we analyzed 456 patients with a mean age of 54.7 years. 305 (66.9%) were female, the median Hunt&Hess grade was 2. 44 patients (9.6%) suffered from hypothyroidism prior to SAH resulting in a significantly higher prevalence than estimated in the general population (5.0%; p<0.001). The proportion of females was significantly elevated (39 females, 88.6%) in this group (p=0.001). Patients with hypothyroidism were significantly older at SAH (59.7 years vs. 54.2 years, p=0.005) and suffered more frequently from arterial hypertension (p<0.001). No statistically relevant difference was found regarding Hunt&Hess grade, size and number of aneurysms, diabetes and occurrence of delayed cerebral ischemia.
Conclusion: The presented retrospective study revealed a significantly higher prevalence of hypothyroidism at admission in SAH patients than would have been expected from the general population. Confirmation of this finding in different study populations will be necessary to establish hypothyroidism as a possible contributing factor to SAH.
