The impact of neurological statement severity in subarachoid hemorhhage onset on early patient`s outcome
DOI:
https://doi.org/10.24144/2415-8127.2019.60.31-36Keywords:
Subarachnoid hemorrhage (SAH), saccular aneurysm, computed tomography, World Federation Ne urosergical Society Scale (WFNS), Glasgow Coma Scale (GCS), Hunt-Hess Scale, Glasgow Outcome Scale (GOS).Abstract
Introduction. The hemorrhagic stroke takes 20% in the structure of cerebrovascular diseases. Near 6-8% belongs to subarachnoid hemorrhage, caused by arterial aneurysms rupture[1,3]. 10-15% of subarachnoid hemorrhages are fatal, it means that patients die before they were admitted to a hospital[5]. Investigation and identification of this factors could improve medical support to these patients and determine groups of patients for early or delayed surgical intervention (clipping or endovascular coiling). Aim. To analyze all cases of non-traumatic SAH that have been treated at our clinic since January 2013 to Decem-ber 2016 and to determine the impact of the level of consciousness and focal neurological deficits in SAH onset on the early patient`s outcome (evaluated by known SAH-scales). Materials and methods. 127 patients with aneurismal subarachnoid hemorrhage were evaluated by validated scales (Hunt-Hess, WFNS and Glasgow Coma Scale (GCS)) at our clinic since January 2013 till December 2016. The statistical analisis of this data was performed. Results and discussion. We have found that a higher evaluation level in Hunt-Hess Scale, WFNS and Glasgow Coma Scale in the SAH onset was a reliable predictor of good early outcome. Conversely, level III–V evaluated by this scales was associated with high mortality (p < 0.001). We did not found a significant difference between the sensi-tivity of the scales. The data identified by all of this scales had a high correlation with the GOS scale, indicating that they had a direct effect on the early outcome after SAH. Conclusions. Due to our data all clinical scales are a highly sensitive tool in predicting the early SAH outcome. This conclusions are consistent with the literature data. Hunt-Hess Scale level IV and WFNS level IV–V, as well as lower level of consciousness due to Glasgow Coma Scale have a very unfavorable prognosis.
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