Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I

Jendé L Zijlmans, Bert A Coert, René van den Berg, Marieke E Sprengers, Charles B Majoie, Peter Vandertop, Dagmar Verbaan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Patients with an aneurysmal subarachnoid haemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome.

OBJECTIVE: The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and to determine which factors are associated with unfavourable outcome.

METHODS: For this prospective cohort study 132, consecutive patients (≥ 18 years old) with a WFNS grade I aSAH admitted to our hospital between December 2011 and January 2016 were eligible. Clinical outcome was measured using the modified Rankin Scale (mRS) at six months' follow-up. Unfavourable outcome was defined as an mRS score of 3-6. Univariable analyses were performed using logistic regression models.

RESULTS: Of 116 patients, only five (4%) had an mRS score of 0 and most (65%) had an mRS score of 2. Twenty-five (22%) patients had an unfavourable outcome. Nine (8%) patients died, of whom four during admission. Factors associated with unfavourable outcome (OR; 95% CI) were age (per increasing decade: 1.78; 1.16-2.72), delayed cerebral ischemia (4.32; 1.63-11.44), pneumonia (10.75; 1.94-59.46) and meningitis 28.47 (1.42-571.15).

CONCLUSIONS: Despite their neurologically optimal clinical condition on admission, one out of five WFNS grade I aSAH patients has an unfavourable clinical outcome, or is dead, at six months' follow-up. Additional multivariable analysis in larger patient cohorts is necessary to identify the extent to which preventable complications contribute to unfavourable outcome in these patients.

Original languageEnglish
Pages (from-to)e217-e222
JournalWorld Neurosurgery
Volume118
Early online date29 Jun 2018
DOIs
Publication statusPublished - 1 Oct 2018

Cite this

Zijlmans, J. L., Coert, B. A., den Berg, R. V., Sprengers, M. E., Majoie, C. B., Vandertop, P., & Verbaan, D. (2018). Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I. World Neurosurgery, 118, e217-e222. https://doi.org/10.1016/j.wneu.2018.06.157
Zijlmans, Jendé L ; Coert, Bert A ; den Berg, René van ; Sprengers, Marieke E ; Majoie, Charles B ; Vandertop, Peter ; Verbaan, Dagmar. / Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I. In: World Neurosurgery. 2018 ; Vol. 118. pp. e217-e222.
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title = "Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I",
abstract = "BACKGROUND: Patients with an aneurysmal subarachnoid haemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome.OBJECTIVE: The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and to determine which factors are associated with unfavourable outcome.METHODS: For this prospective cohort study 132, consecutive patients (≥ 18 years old) with a WFNS grade I aSAH admitted to our hospital between December 2011 and January 2016 were eligible. Clinical outcome was measured using the modified Rankin Scale (mRS) at six months' follow-up. Unfavourable outcome was defined as an mRS score of 3-6. Univariable analyses were performed using logistic regression models.RESULTS: Of 116 patients, only five (4{\%}) had an mRS score of 0 and most (65{\%}) had an mRS score of 2. Twenty-five (22{\%}) patients had an unfavourable outcome. Nine (8{\%}) patients died, of whom four during admission. Factors associated with unfavourable outcome (OR; 95{\%} CI) were age (per increasing decade: 1.78; 1.16-2.72), delayed cerebral ischemia (4.32; 1.63-11.44), pneumonia (10.75; 1.94-59.46) and meningitis 28.47 (1.42-571.15).CONCLUSIONS: Despite their neurologically optimal clinical condition on admission, one out of five WFNS grade I aSAH patients has an unfavourable clinical outcome, or is dead, at six months' follow-up. Additional multivariable analysis in larger patient cohorts is necessary to identify the extent to which preventable complications contribute to unfavourable outcome in these patients.",
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Zijlmans, JL, Coert, BA, den Berg, RV, Sprengers, ME, Majoie, CB, Vandertop, P & Verbaan, D 2018, 'Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I' World Neurosurgery, vol. 118, pp. e217-e222. https://doi.org/10.1016/j.wneu.2018.06.157

Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I. / Zijlmans, Jendé L; Coert, Bert A; den Berg, René van; Sprengers, Marieke E; Majoie, Charles B; Vandertop, Peter; Verbaan, Dagmar.

In: World Neurosurgery, Vol. 118, 01.10.2018, p. e217-e222.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I

AU - Zijlmans, Jendé L

AU - Coert, Bert A

AU - den Berg, René van

AU - Sprengers, Marieke E

AU - Majoie, Charles B

AU - Vandertop, Peter

AU - Verbaan, Dagmar

N1 - Copyright © 2018 Elsevier Inc. All rights reserved.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - BACKGROUND: Patients with an aneurysmal subarachnoid haemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome.OBJECTIVE: The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and to determine which factors are associated with unfavourable outcome.METHODS: For this prospective cohort study 132, consecutive patients (≥ 18 years old) with a WFNS grade I aSAH admitted to our hospital between December 2011 and January 2016 were eligible. Clinical outcome was measured using the modified Rankin Scale (mRS) at six months' follow-up. Unfavourable outcome was defined as an mRS score of 3-6. Univariable analyses were performed using logistic regression models.RESULTS: Of 116 patients, only five (4%) had an mRS score of 0 and most (65%) had an mRS score of 2. Twenty-five (22%) patients had an unfavourable outcome. Nine (8%) patients died, of whom four during admission. Factors associated with unfavourable outcome (OR; 95% CI) were age (per increasing decade: 1.78; 1.16-2.72), delayed cerebral ischemia (4.32; 1.63-11.44), pneumonia (10.75; 1.94-59.46) and meningitis 28.47 (1.42-571.15).CONCLUSIONS: Despite their neurologically optimal clinical condition on admission, one out of five WFNS grade I aSAH patients has an unfavourable clinical outcome, or is dead, at six months' follow-up. Additional multivariable analysis in larger patient cohorts is necessary to identify the extent to which preventable complications contribute to unfavourable outcome in these patients.

AB - BACKGROUND: Patients with an aneurysmal subarachnoid haemorrhage (aSAH) and World Federation of Neurosurgical Societies (WFNS) grade I on admission are generally considered to have a good clinical outcome.OBJECTIVE: The objective of this study was to assess the actual clinical outcome of WFNS grade I aSAH patients, and to determine which factors are associated with unfavourable outcome.METHODS: For this prospective cohort study 132, consecutive patients (≥ 18 years old) with a WFNS grade I aSAH admitted to our hospital between December 2011 and January 2016 were eligible. Clinical outcome was measured using the modified Rankin Scale (mRS) at six months' follow-up. Unfavourable outcome was defined as an mRS score of 3-6. Univariable analyses were performed using logistic regression models.RESULTS: Of 116 patients, only five (4%) had an mRS score of 0 and most (65%) had an mRS score of 2. Twenty-five (22%) patients had an unfavourable outcome. Nine (8%) patients died, of whom four during admission. Factors associated with unfavourable outcome (OR; 95% CI) were age (per increasing decade: 1.78; 1.16-2.72), delayed cerebral ischemia (4.32; 1.63-11.44), pneumonia (10.75; 1.94-59.46) and meningitis 28.47 (1.42-571.15).CONCLUSIONS: Despite their neurologically optimal clinical condition on admission, one out of five WFNS grade I aSAH patients has an unfavourable clinical outcome, or is dead, at six months' follow-up. Additional multivariable analysis in larger patient cohorts is necessary to identify the extent to which preventable complications contribute to unfavourable outcome in these patients.

U2 - 10.1016/j.wneu.2018.06.157

DO - 10.1016/j.wneu.2018.06.157

M3 - Article

VL - 118

SP - e217-e222

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -

Zijlmans JL, Coert BA, den Berg RV, Sprengers ME, Majoie CB, Vandertop P et al. Unfavourable outcome in patients with aneurysmal subarachnoid haemorrhage WFNS grade I. World Neurosurgery. 2018 Oct 1;118:e217-e222. https://doi.org/10.1016/j.wneu.2018.06.157