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Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients.

Publication ,  Journal Article
Wang, J; Alotaibi, NM; Akbar, MA; Ayling, OGS; Ibrahim, GM; Macdonald, RL; SAHIT collaborators,
Published in: World Neurosurg
February 2017

BACKGROUND: Transient loss of consciousness (LOC) is one of the most common presentations of aneurysmal subarachnoid hemorrhage (SAH) and may be an indicator of early brain injury. In this study, we examined the association of LOC and functional outcomes in patients with good-grade SAH. METHODS: We searched the Subarachnoid Hemorrhage International Trialists Repository for patients who presented with LOC at ictus of SAH. A propensity score analysis was performed on good-grade patients (defined as World Federation of Neurosurgical Societies grade 1-3) to balance selected covariates between those with and without LOC. The primary outcome was Glasgow Outcome Score (GOS) at 3 months (with poor outcome defined as a GOS of 1-3). Secondary outcomes were delayed cerebral ischemia (DCI), rebleed, length of hospital stay, and time to death. RESULTS: A propensity score-matching algorithm identified 336 patients (168 with and 168 without LOC at ictus). The proportion of patients with poor functional outcome at 3 months was significantly higher in the cohort with LOC at ictus compared with the matched cohort without LOC at ictus (30% vs. 19%; P = 0.02). There was a nonsignificant trend toward greater mortality in the patients with LOC at ictus (19% vs. 13%; P = 0.14). There were no significant differences in the secondary outcomes between the 2 cohorts. CONCLUSIONS: LOC at ictus of SAH is associated with a higher rate of unfavorable functional outcomes but not of mortality, DCI, or rebleed in patients with good-grade SAH. Future studies should further investigate the putative mechanisms through which LOC mediates early brain injury in SAH.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2017

Volume

98

Start / End Page

308 / 313

Location

United States

Related Subject Headings

  • Unconsciousness
  • Treatment Outcome
  • Time Factors
  • Subarachnoid Hemorrhage
  • Recovery of Function
  • Middle Aged
  • Male
  • Humans
  • Female
  • Databases, Factual
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Wang, J., Alotaibi, N. M., Akbar, M. A., Ayling, O. G. S., Ibrahim, G. M., Macdonald, R. L., & SAHIT collaborators, . (2017). Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients. World Neurosurg, 98, 308–313. https://doi.org/10.1016/j.wneu.2016.10.099
Wang, Justin, Naif M. Alotaibi, Muhammad Ali Akbar, Oliver G. S. Ayling, George M. Ibrahim, R Loch Macdonald, and R Loch SAHIT collaborators. “Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients.World Neurosurg 98 (February 2017): 308–13. https://doi.org/10.1016/j.wneu.2016.10.099.
Wang J, Alotaibi NM, Akbar MA, Ayling OGS, Ibrahim GM, Macdonald RL, et al. Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients. World Neurosurg. 2017 Feb;98:308–13.
Wang, Justin, et al. “Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients.World Neurosurg, vol. 98, Feb. 2017, pp. 308–13. Pubmed, doi:10.1016/j.wneu.2016.10.099.
Wang J, Alotaibi NM, Akbar MA, Ayling OGS, Ibrahim GM, Macdonald RL, SAHIT collaborators. Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients. World Neurosurg. 2017 Feb;98:308–313.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

February 2017

Volume

98

Start / End Page

308 / 313

Location

United States

Related Subject Headings

  • Unconsciousness
  • Treatment Outcome
  • Time Factors
  • Subarachnoid Hemorrhage
  • Recovery of Function
  • Middle Aged
  • Male
  • Humans
  • Female
  • Databases, Factual