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The association between fluid balance and outcomes after subarachnoid hemorrhage.

Publication ,  Journal Article
Martini, RP; Deem, S; Brown, M; Souter, MJ; Yanez, ND; Daniel, S; Treggiari, MM
Published in: Neurocrit Care
October 2012

BACKGROUND: We sought to determine the association between early fluid balance and neurological/vital outcome of patients with subarachnoid hemorrhage. METHODS: Hospital admission, imaging, ICU and outcome data were retrospectively collected from the medical records of adult patients with aneurysmal SAH admitted to a level-1 trauma and stroke referral center during a 5-year period. Two groups were identified based on cumulative fluid balance by ICU day 3: (i) patients with a positive fluid balance (n = 221) and (ii) patients with even or negative fluid balance (n = 135). Multivariable logistic regression was used to adjust for age, Hunt-Hess and Fisher scores, mechanical ventilation and troponin elevation (>0.40 ng/ml) at ICU admission. The primary outcome was a composite of hospital mortality or new stroke. RESULTS: Patients with positive fluid balance had worse admission GCS and Hunt-Hess score, and by ICU day 3 had cumulatively received more IV fluids, but had less urine output when compared with the negative fluid balance group. There was no difference in the odds of hospital death or new stroke (adjusted OR: 1.47, 95%CI: 0.85, 2.54) between patients with positive and negative fluid balance. However, positive fluid balance was associated with increased odds of TCD vasospasm (adjusted OR 2.25, 95%CI: 1.37, 3.71) and prolonged hospital length of stay. CONCLUSIONS: Although handling of IV fluid administration was not an independent predictor of mortality or new stroke, patients with early positive fluid balance had worse clinical presentation and had greater resource use during the hospital course.

Duke Scholars

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Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

October 2012

Volume

17

Issue

2

Start / End Page

191 / 198

Location

United States

Related Subject Headings

  • Water-Electrolyte Balance
  • Vasospasm, Intracranial
  • Subarachnoid Hemorrhage
  • Stroke
  • Retrospective Studies
  • Prognosis
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

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Martini, R. P., Deem, S., Brown, M., Souter, M. J., Yanez, N. D., Daniel, S., & Treggiari, M. M. (2012). The association between fluid balance and outcomes after subarachnoid hemorrhage. Neurocrit Care, 17(2), 191–198. https://doi.org/10.1007/s12028-011-9573-0
Martini, Ross P., Steven Deem, Marcia Brown, Michael J. Souter, N David Yanez, Stephen Daniel, and Miriam M. Treggiari. “The association between fluid balance and outcomes after subarachnoid hemorrhage.Neurocrit Care 17, no. 2 (October 2012): 191–98. https://doi.org/10.1007/s12028-011-9573-0.
Martini RP, Deem S, Brown M, Souter MJ, Yanez ND, Daniel S, et al. The association between fluid balance and outcomes after subarachnoid hemorrhage. Neurocrit Care. 2012 Oct;17(2):191–8.
Martini, Ross P., et al. “The association between fluid balance and outcomes after subarachnoid hemorrhage.Neurocrit Care, vol. 17, no. 2, Oct. 2012, pp. 191–98. Pubmed, doi:10.1007/s12028-011-9573-0.
Martini RP, Deem S, Brown M, Souter MJ, Yanez ND, Daniel S, Treggiari MM. The association between fluid balance and outcomes after subarachnoid hemorrhage. Neurocrit Care. 2012 Oct;17(2):191–198.

Published In

Neurocrit Care

DOI

EISSN

1556-0961

Publication Date

October 2012

Volume

17

Issue

2

Start / End Page

191 / 198

Location

United States

Related Subject Headings

  • Water-Electrolyte Balance
  • Vasospasm, Intracranial
  • Subarachnoid Hemorrhage
  • Stroke
  • Retrospective Studies
  • Prognosis
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Logistic Models