gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Baseline and average platelet count can predict the outcome of aneurysmal subarachnoid haemorrhage

Thrombozytenzahl bei Aufnahme und nach Akutbehandlung kann den Outcome von Patienten mit aneurysmatischer Subarachnoidalblutung vorhersagen

Meeting Abstract

  • presenting/speaker Christoph Rieß - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Meltem Gümüs - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Maryam Said - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Thiemo F. Dinger - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Mehdi Chihi - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Marvin Darkwah Oppong - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Yahya Ahmadipour - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Philipp Dammann - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Karsten H. Wrede - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Ulrich Sure - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland
  • Ramazan Jabbarli - Universitätsklinikum Essen, Klinik für Neurochirurgie und Wirbelsäulenchirurgie, Essen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV196

doi: 10.3205/22dgnc190, urn:nbn:de:0183-22dgnc1909

Published: May 25, 2022

© 2022 Rieß 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: Baseline values and the change of platelet count (PLT) during disease were reported to be associated with prognosis of patients with cancer and intensive care treatment. As neuroinflammation and coagulation are supposed to impact the outcome of aneurysmal subarachnoid hemorrhage (SAH), we aimed to evaluate the association between PLT with the course and prognosis of SAH.

Methods: For all consecutive SAH cases treated between 01/2003 and 06/2016 (n=763), PLT at admission (AdmPLT) and the 14-days mean values (MeanPLT) were recorded with subsequent allocation into 4 groups (<150/µl, 150-260/µl, 261-400/µl, >400/µl). Patient characteristics, initial severity of and complications during SAH were correlated with AdmPLT and MeanPLT. Study endpoints were in-hospital mortality and unfavorable outcome at 6-months follow-up (mRS>3).

Results: There was an increase in PLT during SAH (mean: 25.5/µl, range: -164.9 to +255.1). The highest and lowest rates of in-hospital mortality (43.1% vs 12.9%, p<0.0001) and unfavorable outcome (66% vs 28.3%, p<0.0001) were observed for AdmPLT<150/µl and 261-400/µl respectively. MeanPLT<150/µl and between 261-400/µl were also related to the worst and best outcomes – in-hospital mortality: 55.3% vs 6.9% (p<0.0001); unfavorable outcome: 78.4% vs 25.1% (p<0.0001). In the multivariate analysis adjusted for relevant confounders, MeanPLT<150/µl and 261-400/µl remained the robust predictors of in-hospital mortality (p<0.0001/p<0.0001) and unfavorable outcome (p=0.005/p=0.004). Moreover, individuals with poorer outcome were less prone to PLT increase during SAH (mean: -9.3 vs +32.8/µl for in-hospital mortality, p<0.0001; mean: +14.4 vs +31.1/µl for unfavorable outcome, p<0.0001). The following baseline characteristics and SAH complications showed significant associations with Adm/MeanPLT values: patients’ age and sex, the history of smoking/alcohol consumption, rebleeding, WFNS grade at admission, intraventricular hemorrhage, intracranial pressure increase, occurrence and timing of cerebral infarcts, and development of sepsis during intensive care treatment.

Conclusion: Low PLT values at admission and their less prominent increase during SAH is strongly linked with poor outcome of SAH. Further analysis is required to clarify the background of this association and potential therapeutic implications.