Epidemiological characteristics and causes of death after Aneurysmal Subarachnoid Hemorrhage – SAH

Authors

  • Jarbas Galvão Universidade Regional de Blumenau
  • Daniela Delwing de Lima Universidade da Região de Joinville - UNIVILLE
  • Leandro José Haas Universidade Regional de Blumenau - FURB https://orcid.org/0000-0002-9175-4670
  • Eduardo Manoel Pereira Universidade da Região de Joinville - UNIVILLE https://orcid.org/0000-0002-5734-626X

DOI:

https://doi.org/10.31686/ijier.vol9.iss6.3148

Keywords:

Cerebral aneurysms, Risk factors, Subarachnoid hemorrhage

Abstract

This study analyzed the epidemiological characteristics and causes of deaths after SAH in patients admitted to a referral hospital in southern Brazil. A hospital database was used, comprising the years 2006-2018, composed of 148 patients. Cross-tabulations and Logistic Regression were performed to determine the odds of death of epidemiological characteristics. Ruptured aneurysms had a higher incidence in women, aged between 41 and 60 years. Headache is the predominant symptom in 95% patients. Hypertension (61%) and smoking (47%) are the prevalent risk factors. The age group with the highest frequency of deaths is 71 to 80 years old. The causes of death are: external ventricular shunt (34%), ischemic injury (9%), bleeding (7%), cerebral edema (8%), sepsis (28%) and pneumonia (24.3%). Knowing the risk factors and complications involved provide important insights that help in understanding their genesis, treatment and prevention.

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Author Biographies

  • Daniela Delwing de Lima, Universidade da Região de Joinville - UNIVILLE

    Farmacêutica pela Universidade Luterana do Brasil (ULBRA)

    Docente do Programa de Pós-Graduação em Saúde e Meio Ambiente- Universidade da Região de Joinville (UNIVILLE).

    Mestrado e doutorado em Ciências Biológicas (Bioquímica) pela Universidade Federal do Rio Grande do Sul-(UFRGS).

  • Leandro José Haas, Universidade Regional de Blumenau - FURB

    Médico pela Universidade Regional de Blumenau (FURB)

    Docente do Departamento de Medicina (FURB)

    Especialização em Neuroradiologia intervencionista (Fondation Rothschild )

    Neuroradiologia intervencionista (David Geffen School of Medicine, University of California, Los Angeles) e  Neurocirurgia (Sociedade Brasileira de Neurocirurgia

  • Eduardo Manoel Pereira, Universidade da Região de Joinville - UNIVILLE

    Professor adjunto da Universidade da Região de Joinville (UNIVILLE)

    Graduado em Farmácia-Bioquímica pela Universidade Federal de Alfenas

    Mestre em Farmacologia pela Universidade Federal do Paraná

References

-Vivancos J, Gilo F, Frutos R, Maestre J, García-Pastor A, Quintana F, et al. Guidelines for clinical action in subarachnoid hemorrhage. Systematic diagnosis and treatment. Neurology. 2014; 29 (6): 353-70. doi: 10.1016/j.nrl.2012.07.009. DOI: https://doi.org/10.1016/j.nrl.2012.07.009

-Ortega ZJM, Calvo Alonso M, Lomillos Prieto N, Choque Cuba B, Tamarit Degenhardt M, Poveda Núñez P, et al. Hemorragia subaracnoidea aneurismática: avances clínicos. Neurología Argentina. 2017; 9 (2): 96-107. DOI: https://doi.org/10.1016/j.neuarg.2016.11.002

-Cabral N, Goncalves AR, Longo AL, Moro CH, Costa G, Amaral CH, et al. Incidence of stroke subtypes, prognosis and prevalence of risk factors in Joinville, Brazil: a 2 year community based study. J Neurol Neurosurg Psychiatry. 2009; 80 (7): 755-61. DOI: https://doi.org/10.1136/jnnp.2009.172098

-Júnior JR, Telles JPM, da Silva SA, Iglesio RF, Brigido MM, Pereira Caldas JGM, et al. Epidemiological analysis of 1404 patients with intracranial aneurysm followed in a single Brazilian institution. Surgical neurology international. 2019; 10: 249. DOI: https://doi.org/10.25259/SNI_443_2019

-Almeida TAL, Giacomini LV, Niederauer AG, Almeida FGBA, Cho A, Mallmann AB, et al. Epidemiological Profile of Intracerebral Hemorrhage during a 10-Year Period in a Southern Brazilian Region. Arquivos Brasileiros de Neurocirurgia. 2018; 37 (1): 7-12. doi:10.1055/s-0037-1617426. DOI: https://doi.org/10.1055/s-0037-1617426

-Melo-Souza SE. Tratamento das Doenças Neurológicas. 2ª ed. Rio de Janeiro: Guanabara Koogan, 2008, p. 140-142.

-De Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid hemorrhage: a systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007 Dec; 78 (12): 1365-72. doi: 10.1136/jnnp.2007.117655 DOI: https://doi.org/10.1136/jnnp.2007.117655

-Aigner A, Grittner U, Rolfs A, Norrving B, Siegerink B, Busch MA. Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults. Stroke. 2017; 48 (7): 1744-1751. doi: 10.1161 / STROKEAHA.117.016599. DOI: https://doi.org/10.1161/STROKEAHA.117.016599

-Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, Claassen J, Connolly ES, Mayer SA. Subarachnoid hemorrhage: who dies, and why? Crit Care. 2015; 19 (1): 309. doi: 10.1186/s13054-015-1036-0. DOI: https://doi.org/10.1186/s13054-015-1036-0

-Suwatcharangkoon S, Meyers E, Falo C, Schmidt JM, Agarwal S, Claassen J, Mayer SA. Loss of Consciousness at Onset of Subarachnoid Hemorrhage as an Important Marker of Early Brain Injury. JAMA Neurol. 2016; 73 (1): 28-35. DOI: https://doi.org/10.1001/jamaneurol.2015.3188

-Pahl FH, Oliveira MFd, Rotta JM. Natural course of subarachnoid hemorrhage is worse in elderly patients. Arquivos de Neuro-Psiquiatria. 2014; 72 (11): 862-6. DOI: https://doi.org/10.1590/0004-282X20140146

-Huilca Flores JC, Betancourt Nápoles R. Factores de mal pronóstico en pacientes con hemorragia subaracnoidea espontánea atendidos en el Hospital Universitario Manuel Ascunce Domenéch. 2016; 6 (1): 1-8.

-Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012; 43 (6): 1711-37. doi: 10.1161 / STR.0b013e3182587839 DOI: https://doi.org/10.1161/STR.0b013e3182587839

-Vlak MH, Algra A, Brandenburg R, Rinkel GJ. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: A systematic review and meta-analysis. Lancet Neurol. 2011; 10:626-36. DOI: https://doi.org/10.1016/S1474-4422(11)70109-0

-Fillus IC, Oliveira CS, Conte T, Rodrigues CFA et al. Análise dos aneurismas intracranianos operados no Hospital Policlínica Pato Branco - PR. Revista Brasileira de Neurologia e Psiquiatria. 2017; 219 (1): 51-59.

-Rinaldo L, Rabinstein AA, Lanzino G. Elderly age associated with poor functional outcome after rupture of anterior communicating artery aneurysms. J Clin Neurosci. 2016; 34: 108-111. doi: 10.1016/j.jocn.2016.05.006 DOI: https://doi.org/10.1016/j.jocn.2016.05.006

-Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid hemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol. 2009 8 (7): 635-42. DOI: https://doi.org/10.1016/S1474-4422(09)70126-7

-Dasenbrock HH, Rudy RF, Rosalind Lai PM, Smith TR, Frerichs KU, Gormley WB, Aziz-Sultan MA, Du R. Cigarette smoking and outcomes after aneurysmal subarachnoid hemorrhage: a nationwide analysis. J Neurosurg. 2018; 129 (2): 446-457. DOI: https://doi.org/10.3171/2016.10.JNS16748

-GBD 2015 Tobacco Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015. Lancet. 2017; 389 (10082): 1885-1906. DOI: https://doi.org/10.1016/S0140-6736(17)30819-X

-Barua RS, Rigotti NA, Benowitz NL, Cummings KM, Jazayeri M-A, Morris PB, et al. 2018 ACC Expert Consensus Decision Pathway on Tobacco Cessation Treatment. J Am Coll Cardiol. 2018; 72 (2): 3332-65. doi: 10.1016/j.jacc.2018.10.027. DOI: https://doi.org/10.1016/j.jacc.2018.10.027

-Kalkhoran S, Benowitz NL, Nancy A. Rigotti NA. Prevention and Treatment of Tobacco Use. JACC Health Promotion Series. J Am Coll Cardiol. 2018; 72 (9): 1030-45. DOI: https://doi.org/10.1016/j.jacc.2018.06.036

-Goldman L, Ausiello DC. Tratado de Medicina Interna. 24ª ed. Rio de Janeiro: Elsevier; 2014.

-Turcato C, Pereira SW, Ghizoni MF. Hemorragia subaracnóidea. Arquivos Catarinenses de Medicina, 2006; 35 (2): 78-84.

-Asano AGC. Cefaleia sentinela: sinais de alerta de hemorragia subaracnóidea por ruptura de aneurisma intracraniano. Dissertação (Mestrado em Neuropsiquiatria e Ciência do Comportamento) - Universidade Federal de Pernambuco CSS, Pernambuco; 2006. 49 p. Disponível em:

https://repositorio.ufpe.br/bitstream/123456789/8554/1/arquivo8620_1.pdf

Acesso em: 14 fev. 2021.

-Silva GC, Seixas LM, Nobre MCL, Faria RMS, Lopes RDAL, Rodrigues TA. Perfil clínico e terapêutico dos pacientes vítimas de hemorragia subaracnóidea não traumática no sistema único de saúde no município de Barbacena - MG. Revista Médica de Minas Gerais. 2014; 24 (3): 327-336. DOI: https://doi.org/10.5935/2238-3182.20140099

-Backes D, Rinkel GJ, Sturkenboom AJ, Vergouwen MD. Time-dependent test characteristics of neck stiffness in patients suspected of nontraumatic subarachnoid hemorrhage. J Neurol Sci. 2015; 15; 355 (1-2): 186-8. DOI: https://doi.org/10.1016/j.jns.2015.06.016

-Long B, Koyfman A, Runyon MS. Subarachnoid Hemorrhage: Updates in Diagnosis and Management. Emerg Med Clin North Am. 2017; 35 (4): 803-824. DOI: https://doi.org/10.1016/j.emc.2017.07.001

-Helbok R, Kurtz P, Vibbert M, Schmidt MJ, Fernandez L, Lantigua H, et al. Early neurological deterioration after subarachnoid hemorrhage: risk factors and impact on outcome. J Neurol Neurosurg Psychiatry. 2013; 84 (3): 266-70. DOI: https://doi.org/10.1136/jnnp-2012-302804

-Lantigua H, Ortega-Gutierrez S, Schmidt JM, Lee K, Badjatia N, Agarwal S, Claassen J, Connolly ES, Mayer SA. Subarachnoid hemorrhage: who dies, and why? Crit Care. 2015 Aug 31; 19 (1): 309. doi: 10.1186/s13054-015-1036-0. DOI: https://doi.org/10.1186/s13054-015-1036-0

- Lepski G, Lobão CAF, Taylor S, Mesquita Filho PM, Tatagiba M. Bleeding risk of small intracranial aneurysms in a population treated in a reference center. Arq Neuropsiquiatr. 2019; 77 (5): 300-309. doi: 10.1590/0004-282X20190046. DOI: https://doi.org/10.1590/0004-282x20190046

-Martins PA, Rafael NG, Mário OTM, Ghizoni E. Hemorragia subaracnóidea aneurismática: análise da evolução dos pacientes internados em um hospital de Tubarão. Arq. Catarin. Med. 2012; 41 (4): 19-25.

-Loureiro AB, Vivas MC, Cacho RO, Cacho EWA, Borges G. Evolução Funcional de Pacientes com Hemorragia Subaracnóide Aneurismática não Traumática / Functional Outcome of Patients With Non-Traumatic Aneurysmal Subarachnoid Hemorrhage Rev. bras. ciênc. Saúde. 2015; 19 (2): 123-128. doi:10.4034/RBCS.2015.19.02.06 DOI: https://doi.org/10.4034/RBCS.2015.19.02.06

-Duan Z, Li Y, Guan S, Ma C, Han Y, Ren X, et al. Morphological parameters and anatomical locations associated with rupture status of small intracranial aneurysms. Scientific Reports. 2018; 8. https://doi.org/10.1038/s41598-018-24732-1 DOI: https://doi.org/10.1038/s41598-018-24732-1

-Giraldo EA, Mandrekar JN, Rubin MN, Dupont SA, Zhang Y, Lanzino G, et al. Momento da avaliação do grau clínico e desfecho desfavorável em pacientes com hemorragia subaracnoide aneurismática. Journal of Neurosurgery 2012; 117: 15-9.

-Langham J, Reeves BC, Lindsay KW, van der Meulen JH, Kirkpatrick PJ, Ghol-kar AR, et al. Variação no resultado após hemorragia subaracnóide: um estudo de unidades neurocirúrgicas no Reino Unido e na Irlanda. Stroke 2009; 1: 111-8. DOI: https://doi.org/10.1161/STROKEAHA.108.517805

-Frontera JA, Fernandez A, Schmidt JM, Claassen J, Wartenberg KE, Badjatia N, Parra A, Connolly ES, Mayer SA. Impact of nosocomial infectious complications after subarachnoid hemorrhage. Neurosurgery. 2008; 62 (1): 80-7. doi: 10.1227/01. DOI: https://doi.org/10.1227/01.NEU.0000311064.18368.EA

-Miller BA, Turan N, Chau M, Pradilla G. (2014). Inflammation, vasospasm and brain injury after subarachnoid hemorrhage. BioMed Research International, 2014; 1-16. doi: 10.1155 / 2014/384342

-Douds GL, Tadzong B, Agarwal AD, Krishnamurthy S, Lehman EB, Cockroft KM. Influence of Fever and hospital-acquired infection on the incidence of delayed neurological deficit and poor outcome after aneurysmal subarachnoid hemorrhage. Neurology research international. 2012; 2012: 479865. DOI: https://doi.org/10.1155/2012/479865

-Poulard F, Dimet J, Martin-Lefevre L, Bontemps F, Fiancette M, Clementi E, Lebert C, Renard B, Reignier J. Impact of not measuring residual gastric volume in mechanically ventilated patients receiving early enteral feeding: a prospective before-after study. JPEN J Parenter Enteral Nutr. 2010; 34 (2): 125-30. doi: 10.1177/0148607109344745. DOI: https://doi.org/10.1177/0148607109344745

-Lackner P, Mueller C, Beer R, Broessner G, Fischer M, Helbok R, Schiefecker A, Schmutzhard E, Pfausler B. Nosocomial Infections and Antimicrobial Treatment in Coiled Patients with Aneurysmal Subarachnoid Hemorrhage. Curr Drug Targets. 2017; 18 (12): 1417-1423. doi: 10.2174/1389450117666160401124426. DOI: https://doi.org/10.2174/1389450117666160401124426

-Oddo M, Milby A, Chen I, Chickens S, MacMurtrie E, Maloney-Wilensky E, et al. Hemoglobin concentration and cerebral metabolism in patients with aneurysmatic subarachnoid hemorrhage. Brainstroke. 2009; 40: 1275-81. doi: 10.1161 / STROKEAHA.108.527911 DOI: https://doi.org/10.1161/STROKEAHA.108.527911

-English SW, Chassé M, Turgeon AF, Tinmouth A, Boutin A, Pagliarello G, Fergusson D, McIntyre L. Transfusão de hemácias e efeito da mortalidade em hemorragia subaracnóide aneurismática: uma revisão sistemática e protocolo de meta-análise. Syst Rev. 2015, 3 de abril; 4: 41. doi: 10.1186 / s13643-015-0035-1. PMID: 25927348; PMCID: PMC4392797. DOI: https://doi.org/10.1186/s13643-015-0035-1

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Published

2021-06-01

How to Cite

Galvão, J., Delwing de Lima, D., Haas, L. J., & Pereira, E. M. (2021). Epidemiological characteristics and causes of death after Aneurysmal Subarachnoid Hemorrhage – SAH. International Journal for Innovation Education and Research, 9(6), 66-79. https://doi.org/10.31686/ijier.vol9.iss6.3148
Received 2021-04-25
Accepted 2021-05-11
Published 2021-06-01