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Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage

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Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage. / Hostettler, Isabel C; Kreiser, Kornelia; Lange, Nicole; Schwendinger, Nina; Trost, Dominik; Frangoulis, Samira; Hirle, Theresa; Gempt, Jens; Wostrack, Maria; Meyer, Bernhard.

In: J NEUROL, Vol. 269, No. 10, 10.2022, p. 5553-5560.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hostettler, IC, Kreiser, K, Lange, N, Schwendinger, N, Trost, D, Frangoulis, S, Hirle, T, Gempt, J, Wostrack, M & Meyer, B 2022, 'Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage', J NEUROL, vol. 269, no. 10, pp. 5553-5560. https://doi.org/10.1007/s00415-022-11212-w

APA

Hostettler, I. C., Kreiser, K., Lange, N., Schwendinger, N., Trost, D., Frangoulis, S., Hirle, T., Gempt, J., Wostrack, M., & Meyer, B. (2022). Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage. J NEUROL, 269(10), 5553-5560. https://doi.org/10.1007/s00415-022-11212-w

Vancouver

Hostettler IC, Kreiser K, Lange N, Schwendinger N, Trost D, Frangoulis S et al. Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage. J NEUROL. 2022 Oct;269(10):5553-5560. https://doi.org/10.1007/s00415-022-11212-w

Bibtex

@article{52841a8ebf8b4dd2a7763ebda391d9e7,
title = "Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage",
abstract = "BACKGROUND: Aneurysm treatment during cerebral vasospasm (CVS) phase is frequently considered as particularly dangerous, mainly because of the risk of cerebral infarct.OBJECTIVE: We aimed to evaluate the risk of aneurysmal subarachnoid haemorrhage (aSAH)-specific complications and functional outcome in patients treated during CVS phase.METHODS: We retrospectively analysed a large, retro- and prospectively collected database of aSAH patients admitted to our department between March 2006 and March 2020. We conducted a uni- and multivariable logistic regression analysis to evaluate influencing factors on rebleeding, cerebral infarct, Glasgow Outcome Score (GOS) at discharge and mortality and assessed the rate of angiographic vasospasm on admission.RESULTS: We included 853 patients. The majority of patients were female (66.6%), mean age was 57.3 years. Out of 853 included patients, 92 (10.8%) were treated during CVS phase, 312 (36.6%) underwent clipping and 541 (63.4%) endovascular treatment. Treatment during CVS phase was significantly associated with cerebral infarct in the multivariable logistic regression analysis, unrelated to the nature of intervention (OR 2.42, 1.29-4.54 95% CI p-value = 0.006). However, patients treated during CVS phase did not have increased risk of unfavourable outcome by GOS on discharge. In addition, they did not have a higher rate of rebleeding or mortality.CONCLUSIONS: Treatment during CVS phase was significantly associated with a higher rate of cerebral infarct as confirmed by imaging. This did not reflect on GOS on discharge, rebleeding, or mortality. Aneurysm treatment during CVS phase is relatively safe and should not be postponed due to the risk of rebleeding and subsequent devastating deterioration.",
keywords = "Angiography/adverse effects, Cerebral Infarction/complications, Female, Humans, Intracranial Aneurysm/complications, Male, Middle Aged, Retrospective Studies, Subarachnoid Hemorrhage/complications, Treatment Outcome, Vasospasm, Intracranial/diagnostic imaging",
author = "Hostettler, {Isabel C} and Kornelia Kreiser and Nicole Lange and Nina Schwendinger and Dominik Trost and Samira Frangoulis and Theresa Hirle and Jens Gempt and Maria Wostrack and Bernhard Meyer",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = oct,
doi = "10.1007/s00415-022-11212-w",
language = "English",
volume = "269",
pages = "5553--5560",
journal = "J NEUROL",
issn = "0340-5354",
publisher = "D. Steinkopff-Verlag",
number = "10",

}

RIS

TY - JOUR

T1 - Treatment during cerebral vasospasm phase-complication association and outcome in aneurysmal subarachnoid haemorrhage

AU - Hostettler, Isabel C

AU - Kreiser, Kornelia

AU - Lange, Nicole

AU - Schwendinger, Nina

AU - Trost, Dominik

AU - Frangoulis, Samira

AU - Hirle, Theresa

AU - Gempt, Jens

AU - Wostrack, Maria

AU - Meyer, Bernhard

N1 - © 2022. The Author(s).

PY - 2022/10

Y1 - 2022/10

N2 - BACKGROUND: Aneurysm treatment during cerebral vasospasm (CVS) phase is frequently considered as particularly dangerous, mainly because of the risk of cerebral infarct.OBJECTIVE: We aimed to evaluate the risk of aneurysmal subarachnoid haemorrhage (aSAH)-specific complications and functional outcome in patients treated during CVS phase.METHODS: We retrospectively analysed a large, retro- and prospectively collected database of aSAH patients admitted to our department between March 2006 and March 2020. We conducted a uni- and multivariable logistic regression analysis to evaluate influencing factors on rebleeding, cerebral infarct, Glasgow Outcome Score (GOS) at discharge and mortality and assessed the rate of angiographic vasospasm on admission.RESULTS: We included 853 patients. The majority of patients were female (66.6%), mean age was 57.3 years. Out of 853 included patients, 92 (10.8%) were treated during CVS phase, 312 (36.6%) underwent clipping and 541 (63.4%) endovascular treatment. Treatment during CVS phase was significantly associated with cerebral infarct in the multivariable logistic regression analysis, unrelated to the nature of intervention (OR 2.42, 1.29-4.54 95% CI p-value = 0.006). However, patients treated during CVS phase did not have increased risk of unfavourable outcome by GOS on discharge. In addition, they did not have a higher rate of rebleeding or mortality.CONCLUSIONS: Treatment during CVS phase was significantly associated with a higher rate of cerebral infarct as confirmed by imaging. This did not reflect on GOS on discharge, rebleeding, or mortality. Aneurysm treatment during CVS phase is relatively safe and should not be postponed due to the risk of rebleeding and subsequent devastating deterioration.

AB - BACKGROUND: Aneurysm treatment during cerebral vasospasm (CVS) phase is frequently considered as particularly dangerous, mainly because of the risk of cerebral infarct.OBJECTIVE: We aimed to evaluate the risk of aneurysmal subarachnoid haemorrhage (aSAH)-specific complications and functional outcome in patients treated during CVS phase.METHODS: We retrospectively analysed a large, retro- and prospectively collected database of aSAH patients admitted to our department between March 2006 and March 2020. We conducted a uni- and multivariable logistic regression analysis to evaluate influencing factors on rebleeding, cerebral infarct, Glasgow Outcome Score (GOS) at discharge and mortality and assessed the rate of angiographic vasospasm on admission.RESULTS: We included 853 patients. The majority of patients were female (66.6%), mean age was 57.3 years. Out of 853 included patients, 92 (10.8%) were treated during CVS phase, 312 (36.6%) underwent clipping and 541 (63.4%) endovascular treatment. Treatment during CVS phase was significantly associated with cerebral infarct in the multivariable logistic regression analysis, unrelated to the nature of intervention (OR 2.42, 1.29-4.54 95% CI p-value = 0.006). However, patients treated during CVS phase did not have increased risk of unfavourable outcome by GOS on discharge. In addition, they did not have a higher rate of rebleeding or mortality.CONCLUSIONS: Treatment during CVS phase was significantly associated with a higher rate of cerebral infarct as confirmed by imaging. This did not reflect on GOS on discharge, rebleeding, or mortality. Aneurysm treatment during CVS phase is relatively safe and should not be postponed due to the risk of rebleeding and subsequent devastating deterioration.

KW - Angiography/adverse effects

KW - Cerebral Infarction/complications

KW - Female

KW - Humans

KW - Intracranial Aneurysm/complications

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Subarachnoid Hemorrhage/complications

KW - Treatment Outcome

KW - Vasospasm, Intracranial/diagnostic imaging

U2 - 10.1007/s00415-022-11212-w

DO - 10.1007/s00415-022-11212-w

M3 - SCORING: Journal article

C2 - 35729347

VL - 269

SP - 5553

EP - 5560

JO - J NEUROL

JF - J NEUROL

SN - 0340-5354

IS - 10

ER -