Document Detail


Fatal aneurysmal subarachnoid haemorrhage: Causes of 30-day in-hospital case fatalities in a large single-centre historical patient cohort.
MedLine Citation:
PMID:  23128015     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Mortality rates of up to 40% in the early phase following an aneurysmal subarachnoid haemorrhage (SAH) indicate that the overall case-fatality rate is predominantly influenced by the initial phase of the disease. This analysis investigates the in-hospital causes of death (CODs) within 30 days of admission in patients suffering from a SAH. METHODS: Of the 591 consecutive patients with SAHs from ruptured cerebral aneurysms, 85 patients who died within 30 days after admission were analysed. The various CODs were classified as cerebral or non-cerebral events. A Kaplan-Meier survival analysis was performed for the cerebral and non-cerebral CODs to identify the specific chronology of occurrence. RESULTS: The median cumulative fatality was 4 days. A cerebral oedema as a result of initial brain damage after ictus was the predominant COD (n=24, 28.2%; median cumulative fatality, 1 day; IQR, 1-4 days; SEM, 0.680), followed by cerebral infarction caused by delayed cerebral ischaemia (DCI) (n=13, 15.3%; median cumulative fatality, 9 days; IQR, 4-13 days; SEM, 1.379). Renal failure was the predominant non-cerebral COD before cardiac and pulmonary complications (n=6, 7.1%). CONCLUSIONS: Mortalities after SAHs predominantly occur within the first days after ictus. The dominant cerebral cause of death is early initial cerebral oedema, followed by DCI.
Authors:
Kerim Beseoglu; Kathy Holtkamp; Hans-Jakob Steiger; Daniel Hänggi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-2
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  -     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier B.V. All rights reserved.
Affiliation:
Department of Neurosurgery, Heinrich-Heine-Universität, Düsseldorf, Germany. Electronic address: beseoglu@med.uni-duesseldorf.de.
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