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01-12-2013 | Original Article

Response of Brain Oxygen to Therapy Correlates with Long-Term Outcome After Subarachnoid Hemorrhage

Authors: Leif-Erik Bohman, Jared M. Pisapia, Matthew R. Sanborn, Suzanne Frangos, Elsa Lin, Monisha Kumar, Soojin Park, W. Andrew Kofke, Michael F. Stiefel, Peter D. LeRoux, Joshua M. Levine

Published in: Neurocritical Care | Issue 3/2013

Abstract

Background

Brain oxygen (P_btO₂) monitoring can help guide care of poor-grade aneurysmal subarachnoid hemorrhage (aSAH) patients. The relationship between P_btO₂-directed therapy and long-term outcome is unclear. We hypothesized that responsiveness to P_btO₂-directed interventions is associated with outcome.

Methods

Seventy-six aSAH patients who underwent P_btO₂ monitoring were included. Long-term outcome [Glasgow Outcome Score-Extended (GOS-E) and modified Rankin Scale (mRS)] was ascertained using the social security death database and structured telephone interviews. Univariate and multivariate regression were used to identify variables that correlated with outcome.

Results

Data from 64 patients were analyzed (12 were lost to follow-up). There were 530 episodes of compromised P_btO₂ (<20 mmHg) during a total of 7,174 h of monitor time treated with 1,052 interventions. Forty-two patients (66 %) survived to discharge. Median follow-up was 8.5 months (range 0.1–87). At most recent follow-up 35 (55 %) patients were alive, and 28 (44 %) had a favorable outcome (mRS ≤3). In multivariate ordinal regression analysis, only age and response to P_btO₂-directed intervention correlated significantly with outcome. Increased age was associated with worse outcome (coeff. 0.8, 95 % CI 0.3–1.3, p = 0.003), and response to P_btO₂-directed intervention was associated with improved outcome (coeff. −2.12, 95 % CI −4.0 to −0.26, p = 0.03). Patients with favorable outcomes had a 70 % mean rate of response to P_btO₂-directed interventions whereas patients with poor outcomes had a 45 % response rate (p = 0.005).

Conclusions

Response to P_btO₂-directed intervention is associated with improved long-term functional outcome in aSAH patients.

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Title: Response of Brain Oxygen to Therapy Correlates with Long-Term Outcome After Subarachnoid Hemorrhage
Authors: Leif-Erik Bohman
Jared M. Pisapia
Matthew R. Sanborn
Suzanne Frangos
Elsa Lin
Monisha Kumar
Soojin Park
W. Andrew Kofke
Michael F. Stiefel
Peter D. LeRoux
Joshua M. Levine
Publication date: 01-12-2013
Publisher: Springer US
Published in: Neurocritical Care / Issue 3/2013
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-013-9890-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Response of Brain Oxygen to Therapy Correlates with Long-Term Outcome After Subarachnoid Hemorrhage

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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