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Stroke, Vol 19, 1250-1256, Copyright © 1988 by American Heart Association
A Hijdra, J van Gijn, NJ Nagelkerke, M Vermeulen and H van Crevel
Using logistic regression, we analyzed the predictive value of a number of
entry variables with respect to the outcome variables delayed cerebral
ischemia, rebleeding, and poor outcome (death or severe disability) in
patients with aneurysmal subarachnoid hemorrhage. The entry variables were
clinical condition on admission (grades on the Glasgow Coma Scale, Hunt and
Hess system), the amount of subarachnoid and intraventricular blood and the
presence of hydrocephalus on the admission computed tomogram, and
antifibrinolytic treatment with tranexamic acid. We used data from a
prospectively studied population of 176 patients admitted within 72 hours
after subarachnoid hemorrhage. The risk of delayed cerebral ischemia was
best predicted by the amount of subarachnoid blood, intraventricular blood,
and antifibrinolytic treatment irrespective of clinical condition and
hydrocephalus. The site of delayed cerebral ischemia was not related to the
location of the subarachnoid hemorrhage. Antifibrinolytic treatment was the
only entry variable (negatively) predicting the risk of rebleeding. Death
or severe disability after 3 months was best predicted by the amount of
subarachnoid blood and the initial clinical condition reflected by the
grade on the Glasgow Coma Scale.
ARTICLES
Prediction of delayed cerebral ischemia, rebleeding, and outcome after aneurysmal subarachnoid hemorrhage
Department of Neurology, University Hospital Dijkzigt, Rotterdam, The Netherlands.
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