Impact of hospital-acquired complications in long-term clinical outcomes after subarachnoid hemorrhage

Patients with subarachnoid hemorrhage (SAH) usually have prolonged hospitalizations due to the need to closely monitor their neurological status. Therefore, these patients have higher risk of experiencing hospital-acquired complications (HACs), which can complicate their clinical course and recovery...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2020-07, Vol.194, p.105945-105945, Article 105945
Main Authors: Unda, Santiago R., Labagnara, Kevin, Birnbaum, Jessie, Wong, Megan, de Silva, Neranjan, Terala, Harshit, de la Garza Ramos, Rafael, Haranhalli, Neil, Altschul, David J.
Format: Article
Language:English
Subjects:
Aneurysms
Body mass index
Cardiovascular disease
Clinical outcomes
Coronary artery disease
Demographics
Diabetes mellitus
Ethnicity
Heart diseases
Hospital-acquired complications
Hospitals
Hypercholesterolemia
Hypertension
Hyponatremia
Infections
Ischemia
Medical imaging
Mortality
Multivariate analysis
Neurology
Patients
Pneumonia
Respiratory distress syndrome
Risk factors
Sepsis
Statistical analysis
Subarachnoid hemorrhage
Thrombosis
Urinary tract
Urogenital system
Ventricle
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Summary:Patients with subarachnoid hemorrhage (SAH) usually have prolonged hospitalizations due to the need to closely monitor their neurological status. Therefore, these patients have higher risk of experiencing hospital-acquired complications (HACs), which can complicate their clinical course and recovery. However, there is no evidence on the impact of HACs of long-term clinical outcomes. We aimed to identify if HACs are independent risk factors for poor clinical outcomes at 12–18 months of follow-up. Retrospective analysis of 323 patients with SAH diagnosis from 2013 until June 2018. We collected patient-related factors (age, sex, body mass index (BMI), ethnicity), comorbidities (hypertension, smoke status, diabetes, coronary heart diseases, prothrombotic diseases and hypercholesterolemia), clinical variables (Hunt-Hess grade, modified Fisher grade, treatment, delayed cerebral ischemia), aneurysm characteristics (location, size) and HACs (pneumonia, deep vein thrombosis (DVT), urinary tract infection (UTI), external ventricular drainage (EVD) infections, sepsis, hyponatremia and acute respiratory distress syndrome). Poor outcomes were defined as mRS ≥ 3. 204 patients were included in the primary analysis. 82 (40.2%) experienced one or more HACs during their hospital course. Patients that developed HACs have significantly increased ICU (12.1 ± 6.6 vs 24.3 ± 23.6, p 
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2020.105945