[Patients with subarachnoid haemorrhage in poor grade neurological status: Study of prognostic factors]

Abstract

Objective: To evaluate and predict factors influencing prognosis and/or clinical outcome at 6 months in patients with spontaneous subarachnoid haemorrhage, World Federation of Neurosurgical Societies (WFNS) grades iv and v.

Material and methods: This was a retrospective study of a consecutive series of 394 patients admitted to our hospital with clinical and radiological diagnosis of spontaneous subarachnoid haemorrhage, from 1 January 1999 to 30 June 2009. We selected 121 patients who met the criteria of being in WFNS grades iv or v before treatment; 3 patients were excluded due to loss of tracking. The outcome variable was assessed 6 months after the event using the Glasgow Outcome Scale. A P value<.05 was considered statistically significant.

Results: One hundred and twenty-one patients were included in the statistical analysis. The average age of the patients in the series was 54 years (14-92). Patients who had a mean Glasgow Coma Scale lower than 7 points (P<.0001), those who were grade v (P<.0001) in the pre-treatment WFNS scale and those with pupillary disorder (P=.002) had a worse clinical outcome. Likewise, those with associated intraparenchymal hematoma (P=.020) and those not receiving any treatment (P=.020) were also associated with a poor clinical outcome. These results were statistically significant.

Conclusions: Patients admitted with a WFNS grade v and/or presenting pupil disorder and/or intraparenchymal hematoma were associated with worse clinical outcomes.

Keywords: Aneurisma intracraneal; Cirugía; Escala de Coma de Glasgow; Escala de Resultados de Glasgow; Evaluación de resultados de intervenciones terapéuticas; Evaluation of results of therapeutic interventions; Glasgow Coma Scale; Glasgow Outcome Scale; Hemorragia subaracnoidea; Intracranial aneurysm; Subarachnoid haemorrhage; Surgery.