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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Investigating the Relationship between Demographic, Radiological and Clinical Factors and In-Hospital Mortality of
Seyed Hossein Aghamiri1, Negar Mohamadi Khorasani2, Hossein Farshadmoghadam3
1Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Background:
Subarachnoid hemorrhage (SAH) is a life-threatening neurological condition that accounts for approximately 5% of all strokes. This study aimed to evaluate the demographic, clinical, and radiological factors associated with in-hospital mortality in patients with non-traumatic SAH and to assess potential differences before and after the COVID-19 pandemic.
Materials And Methods:
This retrospective analytical study was conducted on 177 patients with non-traumatic SAH admitted to Imam Hossein Hospital, Tehran, from November 2021 to December 2022. Diagnosis was confirmed by a neurologist using clinical presentation, imaging, and cerebrospinal fluid analysis. Patients were grouped based on discharge status (deceased vs. survived), and also classified into early- and late- pandemic subgroups based on their admission date. Comparative analyses and binary logistic regression were performed to identify predictors of in-hospital mortality.
Results:
Among 177 patients (mean age: 54.75 years), 36 (20.3%) died during hospitalization. Blood pressure, blood sugar, and level of consciousness at admission were significantly associated with mortality (P 0.05), as were disease severity (Hunt and Hess grade) and angiography status (P 0.001). No significant associations were found for age, sex, hospitalization duration, creatinine, platelets, hypertension, diabetes, or aneurysm characteristics (P 0.05). Logistic regression identified lower Glasgow Coma Scale (GCS) scores (P 0.001) and higher systolic blood pressure (P = 0.004) as independent predictors of mortality. Mortality was higher in the late-pandemic group (23.9% vs. 16.0%), though not statistically significant (P = 0.18).
Conclusion:
Lower GCS scores and elevated systolic blood pressure at admission were independent predictors of in-hospital mortality in patients with non-traumatic SAH. The COVID-19 pandemic period was associated with reduced use of angiography and a trend toward increased mortality, underscoring the importance of maintaining access to timely care during public health crises.
