Changes in the level of cardiac troponine and disorders in pulmonary gas exchange as predictors of short- and long-term outcomes of patients with aneurysm subarachnoid haemorrhage. (2nd November 2017)

• Record Type: Journal Article
• Authors: Burzyńska, Małgorzata; Uryga, Agnieszka; Kasprowicz, Magdalena; Kędziora, Jarosław; Szewczyk, Ewa; Woźniak, Jowita; Jarmundowicz, Włodzimierz; Kübler, Andrzej
• Is Part Of: British journal of neurosurgery. Volume 31:Number 6(2017)
• Page Start: 653
• Page End: 660
• Publication Date: 2017-11-02
• Subjects: Subarachnoid haemorrhage -- cardiopulmonary complications -- cardiac troponine -- functional outcome -- predictive modelling; Nervous system -- Surgery -- Periodicals; 617.48
• DOI: 10.1080/02688697.2017.1339301
• Languages: English
• ISSNs: 0268-8697

Abstract

Abstract: Subject: Cardiopulmonary abnormalities are common after aneurysmal subarachnoid haemorrhage ( aSAH ). However, the relationship between short- and long-term outcome is poorly understood. In this paper, we present how cardiac troponine elevations ( cTnI ) and pulmonary disorders are associated with short- and long-term outcomes assessed by the Glasgow Outcome Scale ( GOS ) and Extended Glasgow Outcome Scale ( GOSE ). Methods: A total of 104 patients diagnosed with aSAH were analysed in the study. The non-parametric U Mann-Whitney test was used to evaluate the difference between good ( GOS IV-V, GOSE V-VIII) and poor ( GOS I-III, GOSE I-IV) outcomes in relation to cTnI elevation and pulmonary disorders. Outcome was assessed at discharge from the hospital, and then followed up 6 and 12 months later. Pulmonary disorders were determined by the PaO2 /FiO2 ratio and radiography. The areas under the ROC curves ( AUCs ) were used to determine the predictive power of these factors. Results: In the group with good short-term outcomes cTnI elevation on the second day after aSAH was significantly lower ( p = .00007) than in patients with poor short-term outcomes. The same trend was observed after 6 months, although there were different results 12 months from the onset ( p = .024 and n.s., respectively). A higher peak of cTnI was observed in the group with a pathological X-ray ( p = .008) and pathological PaO2 /FiO2 ratio ( p ≪ .001). cTnI was an accurate predictor of short-term outcomes ( AUC = 0.741, p ≪ .001) and the outcome after 6 months ( AUC = 0.688, p = .015). Conclusion: The results showed that cardiopulmonary abnormalities perform well as predictive factors for short- and long-term outcomes after aSAH .