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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
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Why Do Patients with Poor-Grade Subarachnoid Hemorrhage Die?
Jantien Hoogmoed1, Airton L de Oliveira Manoel2, Bert A Coert1
1Department of Neurosurgery, Neurosurgical Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands.
World Neurosurgery
|August 10, 2019
Summary
Withdrawal of life support was the primary cause of death in poor-grade subarachnoid hemorrhage (SAH) patients. Further research is needed to understand the reasons for these decisions and improve patient outcomes.
Area of Science:
- Neurosurgery
- Critical Care Medicine
- Neurology
Background:
- Poor-grade subarachnoid hemorrhage (SAH) is associated with high mortality.
- The precise causes of death in SAH patients remain largely unknown.
- Understanding mortality patterns is crucial for improving patient care.
Purpose of the Study:
- To investigate the causes of death in patients with poor-grade SAH (World Federation of Neurosurgical Societies grade IV or V).
- To identify the primary drivers of mortality in this high-risk patient population.
Main Methods:
- Retrospective analysis of consecutive patients with poor-grade SAH admitted between 2009 and 2013.
- Data collected from two tertiary referral centers in Amsterdam and Toronto.
- Included patients who died during their hospital stay.
Main Results:
- 152 out of 357 (43%) patients died during hospitalization.
- Withdrawal of life support was the leading cause of death (71%), followed by brain death (15%).
- A significant proportion (24%) did not undergo aneurysm treatment.
Conclusions:
- The decision to withdraw life support overwhelmingly contributed to mortality in poor-grade SAH patients.
- Underlying reasons for life support withdrawal, beyond cultural/referral factors, require further investigation.
- Prospective studies are essential to elucidate death determinants and enhance clinical management for poor-grade SAH.
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