Publications

Authors:

Panni, Pietro; Simionato, Franco; Cao, Roberta; Pedicelli, Alessandro; Marchese, Enrico; Caricato, Anselmo; Alexandre, Andrea; 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; Aspide, Raffaele; Lanterna, Andrea Luigi; Ambrosi, Alessandro; Mortini, Pietro; Azzolini, Maria Luisa; Calvi, Maria Rosa; Falini, Andrea

Title:

Hemorrhage volume drives early brain injury and outcome in poor-grade aneurysmal SAH

Year:

2024

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

A Stampa

Referee:

Sì

Name of journal:

American Journal of Neuroradiology

ISSN of journal:

0195-6108

N° Volume:

45

Number or Folder:

4

Page numbers:

393-399

Keyword:

global intracranial hemorrhage volum; global cerebral edema development; early brain injury; long-term clinical outcome; mortality; predictors

Short description of contents:

Background and purpose: Early brain injury is a major determinant of clinical outcome in poor-grade (World Federation of Neurosurgical Societies [WFNS] IV-V) aneurysmal SAH and is radiologically defined by global cerebral edema. Little is known, though, about the effect of global intracranial hemorrhage volume on early brain injury development and clinical outcome. Materials and methods: Data from the multicentric prospective Poor-Grade Aneurysmal Subarachnoid Hemorrhage (POGASH) Registry of consecutive patients with poor-grade aneurysmal SAH admitted from January 1, 2015, to August 31, 2022, was retrospectively evaluated. Poor grade was defined according to the worst-pretreatment WFNS grade. Global intracranial hemorrhage volume as well as the volumes of intracerebral hemorrhage, intraventricular hemorrhage, and SAH were calculated by means of analytic software in a semiautomated setting. Outcomes included severe global cerebral edema (defined by Subarachnoid Hemorrhage Early Brain Edema Score grades 3-4), in-hospital mortality (mRS 6), and functional independence (mRS 0-2) at follow-up. Results: Among 400 patients (median global intracranial hemorrhage volume of 91 mL; interquartile range, 59-128), severe global cerebral edema was detected in 218/400 (54.5%) patients. One hundred twenty-three (30.8%) patients died during the acute phase of hospitalization. One hundred fifty-five (38.8%) patients achieved mRS 0-2 at a median of 13 (interquartile range, 3-26) months of follow-up. Multivariable analyses showed global intracranial hemorrhage volume as independently associated with severe global cerebral edema (adjusted OR, 1.009; 95% CI, 1.004-1.014; P < .001), mortality (adjusted OR, 1.006; 95% CI, 1.001-1.01; P = .018) and worse clinical outcome (adjusted OR, 0.992; 95% CI, 0.98-0.996; P < .010). The effect of global intracranial hemorrhage volume on clinical-radiologic outcomes changed significantly according to different age groups (younger than 50, 50-70, older than 70 year of age). Volumes of intracerebral hemorrhage, intraventricular hemorrhage, and SAH affected the 3 predefined outcomes differently. Intracerebral hemorrhage volume independently predicted global cerebral edema and long-term outcome, intraventricular hemorrhage volume predicted mortality and long-term outcome, and SAH volume predicted long-term clinical outcome. Conclusions: Global intracranial hemorrhage volume plays a pivotal role in global cerebral edema development and emerged as an independent predictor of both mortality and long-term clinical outcome. Aging emerged as a reducing predictor in the relationship between global intracranial hemorrhage volume and global cerebral edema.

Web page:

https://doi.org/10.3174/ajnr.A8135
http://www.ajnr.org/content/early/2024/03/07/ajnr.A8135

Product ID:

138506

Handle IRIS:

11562/1121775

Last Modified:

April 26, 2024

Bibliographic citation:

Panni, Pietro; Simionato, Franco; Cao, Roberta; Pedicelli, Alessandro; Marchese, Enrico; Caricato, Anselmo; Alexandre, Andrea; 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; Aspide, Raffaele; Lanterna, Andrea Luigi; Ambrosi, Alessandro; Mortini, Pietro; Azzolini, Maria Luisa; Calvi, Maria Rosa; Falini, Andrea, Hemorrhage volume drives early brain injury and outcome in poor-grade aneurysmal SAH «American Journal of Neuroradiology» , vol. 45 , n. 4 , 2024 , pp. 393-399

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