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Multicenter Study
. 2023 Feb;165(2):443-449.
doi: 10.1007/s00701-022-05464-8. Epub 2023 Jan 12.

The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

Elisabeth Ronne Engström  1 , Bryndís Baldvinsdóttir  2 , Helena Aineskog  3 , Peter Alpkvist  4 , Per Enblad  5 , Johanna Eneling  6 , Steen Fridriksson  7 , Jan Hillman  6 , Paula Klurfan  7 , Erik Kronvall  2 , Peter Lindvall  3 , Ann-Christin Von Vogelsang  4 , Ola G Nilsson  2 , Mikael Svensson  4
Affiliations
Multicenter Study

The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

Elisabeth Ronne Engström et al. Acta Neurochir (Wien). 2023 Feb.

Abstract

Purpose: There is an an increasing awareness of the importance of health and lifestyle for stroke diseases like spontaneous subarachnoid hemorrhage (SAH). However, the importance of pre-existing medical conditions for clinical course and mortality after SAH has not been studied. The aim of the present study was to identify pre-existing conditions contributing to mortality after SAH.

Methods: Data were extracted from a Swedish national prospective study on patients with SAH. Variables were defined for age, sex, body mass index (BMI), clinical condition at admission, and for 10 pre-existing medical conditions. Models predicting mortality in three time intervals with all possible subsets of these variables were generated, compared and selected using Akaike's information criterion.

Results: 1155 patients with ruptured aneurysms were included. The mortality within 1 week was 7.6%, 1 month 14.3%, and 1 year 18.7%. The most common pre-existing medical conditions were smoking (57.6%) and hypertension (38.7%). The model's best predicting mortality within 1 week and from 1 week to 1 month included only the level of consciousness at admission and age, and these two variables were present in all the models among the top 200 in Akaike score for each time period. The most predictive model for mortality between 1 month and 1 year added previous stroke, diabetes, psychiatric disease, and BMI as predictors.

Conclusion: Mortality within the first month was best predicted simply by initial level of consciousness and age, while mortality within from 1 month to 1 year was significantly influenced by pre-existing medical conditions.

Keywords: Medical conditions; Mortality; National prospective study; Previous health; Spontaneous subarachnoid hemorrhage.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
This figure shows the distribution of the numbers of pre-existing medical conditions
See this image and copyright information in PMC

References

    1. Cesarini KG, Hardemark HG, Persson L. Improved survival after aneurysmal subarachnoid hemorrhage: review of case management during a 12-year period. J Neurosurg. 1999;90:664–672. doi: 10.3171/jns.1999.90.4.0664. - DOI - PubMed
    1. Chen Y, Wright N, Guo Y, Turnbull I, Kartsonaki C, Yang L, Bian Z, Pei P, Pan D, Zhang Y, Qin H, Wang Y, Lv J, Liu M, Hao Z, Wang Y, Yu C, Peto R, Collins R, Li L, Clarke R, Chen Z, China Kadoorie Biobank Collaborative G Mortality and recurrent vascular events after first incident stroke: a 9-year community-based study of 0.5 million Chinese adults. Lancet Glob Health. 2020;8:e580–e590. doi: 10.1016/S2214-109X(20)30069-3. - DOI - PMC - PubMed
    1. Chen S, Mao J, Chen X, Li Z, Zhu Z, Li Y, Jiang Z, Zhao W, Wang Z, Zhong P, Huang Q. Association between body mass index and intracranial aneurysm rupture: a multicenter retrospective study. Front Aging Neurosci. 2021;13:716068. doi: 10.3389/fnagi.2021.716068. - DOI - PMC - PubMed
    1. Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K, Cercy K, Murray CJL, Forouzanfar MH, Global Burden of Diseases I. Risk Factors S. Stroke Experts Writing G Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol. 2016;15:913–924. doi: 10.1016/S1474-4422(16)30073-4. - DOI - PubMed
    1. Grossen AA, Shi HH, O'Neal CM, Bauer AM. Impact of obesity and diabetes on postoperative outcomes following surgical treatment of nontraumatic subarachnoid hemorrhage: analysis of the ACS-NSQIP database. World Neurosurg. 2022;163:e290–e300. doi: 10.1016/j.wneu.2022.03.113. - DOI - PubMed

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