Evolution of neurological recovery during the first year after subarachnoid haemorrhage in a French university centre - 09/05/19
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Abstract |
Introduction |
The evolution of neurological recovery during the first year after aneurysmal Subarachnoid Haemorrhage (SAH) is poorly described.
Patients |
Patients with SAH in one university hospital from March the 1st 2010, to December 31st 2012, with a one-year follow-up.
Method |
Evaluation was performed via phone call at 3, 6 and 12 months. Primary endpoint was poor neurological recovery (modified Rankin Scale 3–4–5–6), one year after SAH. Secondary endpoints were the incidence of lack of self-perceived previous health status recovery and incidence of cognitive disorders, one year after SAH. Risk factors of poor neurological recovery were retrieved with multivariable logistic regression.
Results |
Two hundred and eleven patients were included and 208 had a complete follow-up. One hundred and twenty (57.7%) patients were female, 112 (53.8%) had a WFNS grade I–II–III. Seventy (33.6%) patients displayed one-year poor neurological outcome and risk factors of poor outcome were age, baseline Glasgow Coma Score ≤ 8, external ventricular drainage, intra-cranial hypertension and angiographic vasospasm. We observed an improvement in good outcome at 3 months [112 (53.8%) patients], 6 months [127 (61.1%) patients] and one-year [138 (66.3%) patients]. Fifty-nine (35.3%) patients recovered previous health status, 96 (57.5%) had persistent behaviour disorders, and 71 (42.5%) suffered from memory losses at one year.
Discussion |
Neurological recovery seems to improve over time. The same key complications should be targeted worldwide in SAH patients.
Conclusion |
Neurological complications in the following of SAH should be actively treated in order to improve outcome. The early neuro-ICU phase remains a key determinant of long-term recovery.
Le texte complet de cet article est disponible en PDF.Keywords : Subarachnoid haemorrhage, Outcome, Recovery
Plan
Vol 38 - N° 3
P. 251-257 - juin 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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