What question did this study set out to answer?

To analyze baseline clinical characteristics, functional outcomes, and prognostic risk factors in patients presenting with non-aneurysmal, non-traumatic subarachnoid hemorrhage.

July 1, 2014BMC NeurologyOpen Access

Non-aneurysmal non-traumatic subarachnoid hemorrhage: patient characteristics, clinical outcome and prognostic factors based on a single-center experience in 125 patients

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Non-aneurysmal non-traumatic subarachnoid hemorrhage (n=125). Intervention: Poor admission status (WFNS IV-V) vs. Good admission status (WFNS I-III). Primary outcome: Unfavorable outcome (modified Rankin Scale 3-6) at 6 months (OR 13.2, 95% CI 4-40, p=<0.001).

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Key result

Poor admission status was the only independent predictor of unfavorable outcome at 6 months in patients with spontaneous non-aneurysmal subarachnoid hemorrhage (OR 13.2).

Population

125 patients with spontaneous non-aneurysmal subarachnoid hemorrhage, mean age 56.4 years, 70% male…

Design

Cohort

Follow-up

6 months

Authors

JKJuergen KonczallaGoethe University Frankfurt JPJohannes PlatzGoethe University Frankfurt PSPatrick SchussUnfallkrankenhaus Berlin

Discussion

Member takes

Implication

Supports risk stratification by admission status in non-aneurysmal SAH; leaves open prospective validation of targeted interventions.

Key Points

To analyze baseline clinical characteristics, functional outcomes, and prognostic risk factors in patients presenting with non-aneurysmal, non-traumatic subarachnoid hemorrhage.
Prospective database analysis of 125 consecutive patients presenting with non-aneurysmal subarachnoid hemorrhage between 1999 and 2009 at a single center.
All patients underwent repetitive cerebral angiography and were categorized by blood distribution on initial CT scan into perimesencephalic and non-perimesencephalic groups.
Functional outcome was evaluated using the modified Rankin Scale, defining scores of 0–2 as favorable and 3–6 as unfavorable.
Overall favorable outcome was achieved in 83% of patients (104 of 125), with 85% (106 of 125) presenting in good admission condition (WFNS grade I–III).
Favorable outcome significantly correlated with younger age (P < 0.001), favorable admission clinical grade (P < 0.0001), and absence of acute hydrocephalus (P = 0.001).
Multivariate analysis identified poor admission status as the only independent predictor of unfavorable outcome, with non-perimesencephalic hemorrhage showing worse neurological risk compared to perimesencephalic patterns (40 of 52 favorable vs. 64 of 73 favorable).

Study Design

Type

Cohort (n=125)

Multicenter

Structured PICO

Population

125 patients with spontaneous non-aneurysmal subarachnoid hemorrhage, followed for 6 months to assess clinical outcomes and prognostic factors.

Outcome

Clinical outcome assessed by the modified Rankin Scale (mRS) at 6 months, dichotomized into favorable (mRS 0-2) vs. unfavorable (mRS 3-6).hard clinical

Main Result

Odds Ratio: 13.2 (95% CI 4–40)

Absolute Event Rate: 57.9% vs 9.4%

p-value: p=<0.001

Patients with non-aneurysmal subarachnoid hemorrhage generally have a favorable prognosis, with poor admission clinical status being the primary driver of unfavorable outcomes at 6 months.

Limitations

Statistical analysis was retrospectively performed
Conducted at a single center
Lack of data not documented initially in the medical records (e.g., initial blood pressure)
Absence of a control group
Follow-up examination was limited to 6 months after ictus
Retrospective statistical analysis
Single center
Lack of some initially documented data like initial blood pressure
Follow-up limited to 6 months

Cite This Study

Konczalla et al. (2014) conducted a cohort in Non-aneurysmal non-traumatic subarachnoid hemorrhage (n=125). Poor admission status (WFNS IV-V) vs. Good admission status (WFNS I-III) was evaluated on Unfavorable outcome (modified Rankin Scale 3-6) at 6 months (OR 13.2, 95% CI 4-40, p=<0.001). Poor admission status was the only independent predictor of unfavorable outcome at 6 months in patients with spontaneous non-aneurysmal subarachnoid hemorrhage (OR 13.2).

synapsesocial.com/papers/6a942869d5a6dcc35cf64673 https://doi.org/10.1186/1471-2377-14-140

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Non-aneurysmal non-traumatic subarachnoid hemorrhage: patient characteristics, clinical outcome and prognostic factors based on a single-center experience in 125 patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Non-aneurysmal non-traumatic subarachnoid hemorrhage: patient characteristics, clinical outcome and prognostic factors based on a single-center experience in 125 patients

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

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