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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le lundi 12 novembre 2018
Doi : 10.1016/j.accpm.2018.10.002
Evolution of neurological recovery during the first year after subarachnoid haemorrhage in a French university centre

Raphaël Cinotti a , Jean-Baptiste Putegnat b , Karim Lakhal c , Hubert Desal d , Amandine Chenet e , Kévin Buffenoir f , Denis Frasca g, h , Bernard Allaouchiche i, j, k , Karim Asehnoune a, l , Bertrand Rozec c, m,
a Anaesthesia and critical care department, Hôtel Dieu, 1, place Alexis-Ricordeau 44093 Nantes, university hospital of Nantes, France 
b Anaesthesia and critical care department, centre régional hospitalier universitaire, route de Chauvel, Les Abymes, BP 465, 97159, Pointe-à-Pitre cedex, Guadeloupe, France 
c Anaesthesia and critical care department, hôpital Guillaume et René-Laennec, university hospital of Nantes, boulevard Jacques-Monod, 44800 Saint-Herblain, France 
d Department of neuroradiology, hôpital Guillaume et René-Laennec, university hospital of Nantes boulevard Jacques-Monod, 44800 Saint-Herblain, France 
e Service de médecine physique et de réadaptation, hôpital Saint-Jacques, university hospital of Nantes, 85, rue Saint-Jacques, 44200 Nantes, France 
f Department of neurotraumatology, university hospital of Nantes Hôtel Dieu, 1, place Alexis-Ricordeau 44093 Nantes, France 
g Anaesthesia and critical care department, centre hospitalo-universitaire, university hospital of Poitiers 2, rue de la Milétrie 86021, Poitiers, France 
h Inserm SPHERE U1246 “Methods for Patients-centered outcomes and Health Research”, UFR des sciences pharmaceutiques, university of Nantes, university of Tours, 22, boulevard Benoni-Goullin, 44200 Nantes, France 
i Intensive care unit, anaesthesia and critical care department, centre hospitalier Lyon-Sud, Pierre-Bénite France Hospice Civils de Lyon 165, chemin du Grand Revoyet, 69310, France 
j Université Claude Bernard Lyon 1, 43, boulevard du 11 Novembre 1918, 69100, Villeurbanne, France 
k Université de Lyon, VetAgroSup, APCSé, 1, avenue Bourgelat, 69280, Marcy-l’Etoile, France 
l Laboratoire UPRES EA 3826 “Thérapeutiques cliniques et expérimentales des infections” university hospital of Nantes. 22, boulevard Benoni-Goullin, 44200 Nantes, France 
m Institut du thorax, Inserm UMR1087 IRT, UN 8 quai Moncousu, University hospital of Nantes, BP 7072 44007 Nantes cedex 1, France 

Corresponding author at: Service d’anesthésie-réanimation, hôpital Guillaume et René-Laennec, Boulevard Jacques-Monod, 44800 Saint-Herblain, France.Service d’anesthésie-réanimationhôpital Guillaume et René-LaennecBoulevard Jacques-MonodSaint-Herblain44800France

The evolution of neurological recovery during the first year after aneurysmal Subarachnoid Haemorrhage (SAH) is poorly described.


Patients with SAH in one university hospital from March the 1st 2010, to December 31st 2012, with a one-year follow-up.


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.


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.


Neurological recovery seems to improve over time. The same key complications should be targeted worldwide in SAH patients.


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.

The full text of this article is available in PDF format.

Keywords : Subarachnoid haemorrhage, Outcome, Recovery

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