Factors Influencing the Mortality of Patients With Subarachnoid Haemorrhage

Factors Influencing the Mortality of Patients With Subarachnoid Haemorrhage in the Intensive Care Unit

Spontaneous subarachnoid haemorrhage (SAH) is a serious cerebrovascular disease with high morbidity and mortality.Determining the factors associated with mortality in the ICU follow-up and treatment of patients with spontaneous SAH is very important for clarifying these uncertainties and improving ICU outcomes.In the literature, there are very few studies analysing ICU mortality and mortality-related factors in this patient group.The aim of this study was to determine the demographic/clinical characteristics and factors affecting the mortality of spontaneous SAH patients admitted in the ICU.

Study Overview

• Status: Completed
• Conditions: Spontaneous Subarachnoid Hemorrhage
• Intervention / Treatment: Other: Spontaneous subarachnoid haemorrhage survival cohort; Other: Spontaneous subarachnoid haemorrhage mortality cohort

Detailed Description

Patients aged 18 years and older who were diagnosis of spontaneous SAH and admitted the ICU were included in the study. The diagnosis of spontaneous SAH was based on the brain computed tomography (CT) or lumbar puncture. Patients with a final outcome (survival or mortality) in our centre were included in the analysis were included. Only patients admitted to the ICU for the first time were included. Patients with traumatic SAH, history of significant head trauma in the previous two weeks (any abnormality on brain CT requiring hospitalisation for more than 24 hours), pregnancy and length of ICU stay ≤24 hours were excluded.The clinical and radiological severity of the patients at ICU admission was according to Acute Physiological and Chronic Health Evaluation-II score (APACHE II), Glasgow Coma Scale (GCS), Modified Fisher Scale, World Federation of Neurological Societies (WFNS) and Hunt and Hess (H&H) grading systems.Demographic and clinical data derived and analyzed included age, sex, smoking history, comorbidities. Presenting signs and symptoms, diagnoses responsible for spontaneous SAH (aneurysm, arterial malformation, etc.), site of aneurysm, risk factors, location of the aneurysm, risk factors, blood pressure during ICU admission, and scores from grading systems indicating clinical and radiological severity of the disease were recorded. Procedures for spontaneous SAH, complications during ICU follow-up (vasospasm, meningitis, electrolyte disturbances, rebleeding, DCI, VIP, sepsis/septic shock) and treatments, duration of ICU stay and mechanical ventilation, ICU outcome (survival or mortality), causes of mortality and brain death status were recorded. According to the outcome of the ICU process, the patients were divided into two groups as survival and mortality.

• Study Type: Observational
• Enrollment (Actual): 117

Contacts and Locations

Study Locations

• Turkey
  • Antalya, Turkey
    • Akdeniz University School of Medicine, Department of Anesthesiology and Intensive Care, Turkey

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Patients aged 18 years and older who were diagnosis of spontaneous SAH and admitted the intensive care unit were included in the study.

Description

Inclusion Criteria:

• Patients aged ≥18 years with a confrmed diagnosis of spontaneous subarachnoid haemorrhage by a brain computed tomography (CT)
• Patients with a final outcome (survival or mortality) in our centre

Exclusion Criteria:

• Patients with traumatic SAH
• History of significant head trauma in the previous two weeks (any abnormality on brain CT requiring hospitalisation for more than 24 hours)
• Pregnancy
• Length of intensive care unit stay ≤24 hours

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Spontaneous subarachnoid haemorrhage survival cohort; Demographic and clinical data derived and analyzed included age, sex, smoking history, comorbidities. Presenting signs and symptoms, diagnoses responsible for spontaneous SAH (aneurysm, arterial malformation, etc.), site of aneurysm, risk factors, location of the aneurysm, risk factors, blood pressure during ICU admission, and scores from grading systems indicating clinical and radiological severity of the disease were recorded. Procedures for spontaneous SAH, complications during ICU follow-up (vasospasm, meningitis, electrolyte disturbances, rebleeding, DCI, VIP, sepsis/septic shock) and treatments, duration of ICU stay and mechanical ventilation, ICU outcome (survival or mortality), causes of mortality and brain death status were recorded.	Other: Spontaneous subarachnoid haemorrhage survival cohort; consists of surviving patients
Spontaneous subarachnoid haemorrhage mortality cohort; Demographic and clinical data derived and analyzed included age, sex, smoking history, comorbidities. Presenting signs and symptoms, diagnoses responsible for spontaneous SAH (aneurysm, arterial malformation, etc.), site of aneurysm, risk factors, location of the aneurysm, risk factors, blood pressure during ICU admission, and scores from grading systems indicating clinical and radiological severity of the disease were recorded. Procedures for spontaneous SAH, complications during ICU follow-up (vasospasm, meningitis, electrolyte disturbances, rebleeding, DCI, VIP, sepsis/septic shock) and treatments, duration of ICU stay and mechanical ventilation, ICU outcome (survival or mortality), causes of mortality and brain death status were recorded.	Other: Spontaneous subarachnoid haemorrhage mortality cohort; consists of deceased patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
determine mortality and causes	determine mortality and its causes in patients with spontaneous subarachnoid haemorrhage	01 January 2019-31 December 2023

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
factors affecting mortality	evaluate the clinical characteristics and factors affecting mortality in subarachnoid haemorrhage	01 January 2019-31 December 2023

Collaborators and Investigators

• Sponsor: Melike Cengiz
• Investigators: Principal Investigator: Ulku Arslan Yildiz, MD, Akdeniz University School of Medicine, Department of Anesthesiology and Intensive Care, Turkey; Principal Investigator: Murat Yilmaz, Professor, Akdeniz University School of Medicine, Department of Anesthesiology and Intensive Care, Turkey; Principal Investigator: Onur Cetinkaya, MD, Akdeniz University School of Medicine, Department of Anesthesiology and Intensive Care, Turkey

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2024
• Primary Completion (Actual): May 1, 2024
• Study Completion (Actual): June 15, 2024

Study Registration Dates

• First Submitted: June 29, 2024
• First Submitted That Met QC Criteria: June 29, 2024
• First Posted (Actual): July 8, 2024

Study Record Updates

• Last Update Posted (Actual): July 8, 2024
• Last Update Submitted That Met QC Criteria: June 29, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: Intensive Care Unit; Mortality; Spontaneous subarachnoid haemorrhage
• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Intracranial Hemorrhages; Hemorrhage; Subarachnoid Hemorrhage
• Other Study ID Numbers: Akdeniz U.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No