The survival rate and the risk factors for death among patients with aneurysmal subarachnoid haemorrhages

Authors


  • Conflict of interest: The authors declare that they have no conflict of interest.

Correspondence: Guang Jian Liu, Department of Neurology,Taihe Hospital Affiliated to Hubei University of Medicine,32 Renmin South Road, Shiyan City, Hubei Province 442000, China.

E-mail: yymclgj65@yahoo.com.cn

Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating disease with high mortality (i.e. 50–60·2% [1, 2]) and disability rates. In order to investigate the survival of patients with aSAH and related risk factors, a retrospective cohort study was conducted at a local hospital.

Eighty-eight subjects (34 males, 54 females, age 52 ± 11 years, 30–78 years) were recruited during 2001–2011 according to the following criteria: (1) exhibited neuroimaging and cerebrospinal fluid signs of aSAH; (2) met the nontraumatic subarachnoid haemorrhage (SAH) diagnosis criteria proposed by Suarez et al. [3]; (3) was diagnosed with intracranial aneurysms via digital subtraction angiography (DSA); (4) <14 days between the onset of aSAH and hospitalization; and (5) age >12 years. Exclusion criteria were a traumatic SAH or intraparenchymal haemorrhage that invaded the subarachnoid cavity and a SAH secondary to an intracranial infection, tumour, stroke, or a haematological disease. Death from aSAH or its complications were used as an outcome indicator. A follow-up survey was performed on the patients. The onset of aSAH was specified as the starting point and death as the end-point of each case. SPSS 15·0 (SPSS Inc, Chicago, IL, USA) was used for statistical analysis.

The results indicated that the death rate was 28·4%, and the cumulative survival rates over one-month, three-months, and one-year were 78%, 77%, and 73%, respectively. The use of nimodipine significantly reduced the risk of death in aSAH patients. Surgical clipping and endovascular embolization remarkably lowered the risk of death in aSAH patients. In addition, multivariate analysis showed that aSAH patients with complications of hyponatraemia, pulmonary infections, gastrointestinal bleeding, or cerebral vasospasm had a significantly higher risk of death.

Hyponatraemia, pulmonary infections, gastrointestinal bleeding, and cerebral vasospasm complications are risk factors that correlate with a poor prognosis for aSAH patients. Surgical clipping, endovascular embolization, or the use of nimodipine significantly reduced the risk of death.

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