Potentially Harmful Ionizing Radiation Exposure from Diagnostic Tests and Medical Procedures in Patients with Aneurysmal Subarachnoid Hemorrhage

Patients with aneurysmal subarachnoid hemorrhage (aSAH) may have significant potentially harmful ionizing radiation exposure (PHIRE) from diagnostic tests and medical procedures (DTMP) during their initial hospitalization. In this single-center, retrospective, observational study, we evaluated the i...

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Bibliographic Details
Published in:World neurosurgery 2020-08, Vol.140, p.e153-e160
Main Authors: Bacon, J. David, Slade, Emily, Smith, Austin L., Allareddy, Greeshma, Duan, Ran, Fraser, Justin F., Hatton, Kevin W.
Format: Article
Language:English
Subjects:
Adult
Aged
Aneurysmal subarachnoid hemorrhage
Female
Hemorrhagic stroke
Humans
Incidence
Male
Middle Aged
Radiation exposure
Radiation Injuries - epidemiology
Radiography - adverse effects
Radiography - methods
Retrospective Studies
Subarachnoid hemorrhage
Subarachnoid Hemorrhage - diagnostic imaging
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Summary:Patients with aneurysmal subarachnoid hemorrhage (aSAH) may have significant potentially harmful ionizing radiation exposure (PHIRE) from diagnostic tests and medical procedures (DTMP) during their initial hospitalization. In this single-center, retrospective, observational study, we evaluated the incidence of PHIRE using all patients with radiographically proven aSAH who survived hospitalization over a 6-year period. Patient data were then used to fit a full logistic regression model, a reduced-variable logistic regression model with least absolute shrinkage and selection operator penalty, and a nonparametric tree-based model. Testing data were then used to calculate each predictive model's accuracy. Of 192 patients included in this study, 69 (35.9%) met criteria for PHIRE. Patients with PHIRE were more likely to have a poor Hunt-Hess Score (40.6% vs. 12.2%, P < 0.0001), a poor modified Fischer Grading Scale score (30.4% vs. 16.3%, P = 0.03), ventriculostomy (91.3% vs. 47.2%, P < 0.0001), vasospasm (81.2% vs. 34.1%, P 
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2020.04.203