Pubblicazioni

Autori:

Panni, Pietro; Riccio, Lucia; Cao, Roberta; Pedicelli, Alessandro; Marchese, Enrico; Caricato, Anselmo; Feletti, Alberto; Testa, Mattia; Zanatta, Paolo; Gitti, Nicola; Piva, Simone; Mardighian, Dikran; Semeraro, Vittorio; Nardin, Giordano; Lozupone, Emilio; Paiano, Giafranco; Picetti, Edoardo; Montanaro, Vito; Petranca, Massimo; Bortolotti, Carlo; Scibilia, Antonino; Cirillo, Luigi; Lanterna, Andrea Luigi; Ambrosi, Alessandro; Mortini, Pietro; Beretta, Luigi; Falini, Andrea

Titolo:

Clinical impact and predictors of aneurysmal rebleeding in poor-grade subarachnoid hemorrhage: results from the National POGASH Registry

Anno:

2023

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Formato:

A Stampa

Referee:

Sì

Nome rivista:

NEUROSURGERY

ISSN Rivista:

0148-396X

N° Volume:

93

Numero o Fascicolo:

3

Editore:

Lippincott, Williams & Wilkins:530 Walnut Street:Philadelphia, PA 19106:(800)638-3030, (301)223-2300, EMAIL: orders@lww.com, INTERNET: http://www.lww.com, Fax: (301)223-2320, (301)223-2320

Intervallo pagine:

636-645

Parole chiave:

Aneurysm; Poor grade; Rebleeding; Subarachnoid hemorrhage

Breve descrizione dei contenuti:

Background: Scarce data are available regarding rebleeding predictors in poor-grade aneurysmal subarachnoid hemorrhage (aSAH). Objectives: To investigate predictors and clinical impact of rebleeding in a national multicentric poor-grade aSAH. Methods: Retrospective analysis of prospectively collected data from the multicentric Poor Grade Aneurysmal Subarachnoid Hemorrhage Study Group (POGASH) registry of consecutive patients treated from January 1, 2015, to June 30th, 2021. Grading was defined as pretreatment World Federation of Neurological Surgeons grading scale IV-V. Ultra-early vasospasm (UEV) was defined as luminal narrowing of intracranial arteries not due to intrinsic disease. Rebleeding was defined as clinical deterioration with evidence of increased hemorrhage on subsequent computed tomography scans, fresh blood from the external ventricular drain, or deterioration before neuroradiological evaluation. Outcome was assessed by the modified Rankin Scale. Results: Among 443 consecutive World Federation of Neurological Surgeons grades IV-V patients with aSAH treated within a median of 5 (IQR 4-9) hours since onset, rebleeding occurred in 78 (17.6%). UEV (adjusted odds ratio [OR] 6.8, 95% CI 3.2-14.4; P < .001) and presence of dissecting aneurysm (adjusted OR 3.5, 95% CI 1.3-9.3; P = .011) independently predicted rebleeding while history of hypertension (adjusted OR 0.4, 95% CI 0.2-0.8; P = .011) independently reduced its chances. 143 (32.3) patients died during hospitalization. Rebleeding emerged, among others, as an independent predictor of intrahospital mortality (adjusted OR 2.2, 95% CI 1.2-4.1; P = .009). Conclusion: UEV and presence of dissecting aneurysms are the strongest predictors of aneurysmal rebleeding. Their presence should be carefully evaluated in the acute management of poor-grade aSAH.

Pagina Web:

https://doi.org/10.1227/neu.0000000000002467

Id prodotto:

133611

Handle IRIS:

11562/1092948

ultima modifica:

19 ottobre 2023

Citazione bibliografica:

Panni, Pietro; Riccio, Lucia; Cao, Roberta; Pedicelli, Alessandro; Marchese, Enrico; Caricato, Anselmo; Feletti, Alberto; Testa, Mattia; Zanatta, Paolo; Gitti, Nicola; Piva, Simone; Mardighian, Dikran; Semeraro, Vittorio; Nardin, Giordano; Lozupone, Emilio; Paiano, Giafranco; Picetti, Edoardo; Montanaro, Vito; Petranca, Massimo; Bortolotti, Carlo; Scibilia, Antonino; Cirillo, Luigi; Lanterna, Andrea Luigi; Ambrosi, Alessandro; Mortini, Pietro; Beretta, Luigi; Falini, Andrea, Clinical impact and predictors of aneurysmal rebleeding in poor-grade subarachnoid hemorrhage: results from the National POGASH Registry «NEUROSURGERY» , vol. 93 , n. 3 , 2023 , pp. 636-645

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo