Hematologic counts as predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

详细信息    查看全文

• 作者：Ivan Rocha Ferreira Da Silva ; MD^a ; ^b ; ^{ivanuerj@gmail.com} ; Joao Antonio Gomes ; MD^c ; ^{joagom@me.com} ; Ari Wachsman ; MD^d ; ^{ari.wachsman@akrongeneral.org} ; Gabriel Rodriguez de Freitas ; MD ; PhD^a ; ^e ; ^{grdefreitas@gmail.com} ; Jose Javier Provencio ; MD^f ; ^{jp3b@virginia.edu}
• 关键词：Subarachnoid hemorrhage ; Intracranial vasospasm ; Inflammation ; Transcranial Doppler sonography
• 刊名：Journal of Critical Care
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：37
• 期：Complete
• 页码：126-129
• 全文大小：277 K
• 卷排序：37

文摘

Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, but currently no single clinical method or ancillary test can reliably predict which subset of patients will develop delayed cerebral ischemia (DCI). The aim of this study was to find hematologic derangements and clinical factors present during the first 7 days after bleeding that could help identify patients at risk for development of DCI.Materials and methodsDatabank analysis of patients with SAH admitted between 2010 and 2012 in a single center. Data from demographics, imaging, laboratory, and clinical factors were collected. Statistical testing was conducted to test for association to the outcome, and multivariate logistic regression was used to design a predictive model.ResultsOf 55 patients, 14 developed DCI (25%). Anemia and leukocytosis on the third day after bleeding were significantly correlated with the outcome (for anemia: P < .032; confidence interval, 1.12-15.16; odds ratio, 4.12; for leukocytosis: P < .046; confidence interval, 1.03-26.13; odds ratio, 5.18). Anemia and leukocytosis were still statistically significant after adjustment for age, sex, modified Fisher scale, and Hunt-Hess scale.ConclusionThe presence of leukocytosis and anemia during the third day after SAH was statistically correlated with the occurrence of DCI.