• J Joep van der Harst, EltingJan Willem JJWJDepartment of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., BokkersReinoud P HRPHDepartment of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., VeegerNic J G MNJGMDepartment of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Carlina E van Donkelaar, Walter M van den Bergh, MetzemaekersJan D MJDMDepartment of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., GroenRob J MRJMDepartment of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Aryan Mazuri, Gert-Jan R Luijckx, van DijkJ Marc CJMCDepartment of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., and Maarten Uyttenboogaart.
• Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: j.j.van.der.harst@umcg.nl.
• World Neurosurg. 2023 Oct 1; 178: e202e212e202-e212.

ObjectiveNear-infrared spectroscopy (NIRS) is a noninvasive tool to monitor cerebral regional oxygen saturation. Impairment of microvascular circulation with subsequent cerebral hypoxia during delayed cerebral ischemia (DCI) is associated with poor functional outcome after subarachnoid hemorrhage (SAH). Therefore, NIRS could be useful to predict the risk for DCI and functional outcome. However, only limited data are available on NIRS regional cerebral tissue oxygen saturation (rSO2) distribution in SAH. The aim of this study was to compare the distribution of NIRS rSO2 values in patients with nontraumatic SAH with the occurrence of DCI and functional outcome at 2 months. In addition, the predictive value of NIRS rSO2 was compared with the previously validated SAFIRE grade (derived from Size of the aneurysm, Age, FIsher grade, World Federation of Neurosurgical Societies after REsuscitation).MethodsIn this study, the rSO2 distribution of patients with and without DCI after SAH was compared. The optimal cutoff points to predict DCI and outcome were assessed, and its predictive value was compared with the SAFIRE grade.ResultsOf 41 patients, 12 developed DCI, and 9 had unfavorable outcome at 60 days. Prediction of DCI with NIRS had an area under the curve of 0.77 (95% confidence interval 0.62-0.92; P = 0.0028) with an optimal cutoff point of 65% (sensitivity 1.00; specificity 0.45). Prediction of favorable outcome with NIRS had an area under the curve of 0.86 (95% confidence interval 0.74-0.98; P = 0.0003) with an optimal cutoff point of 63% (sensitivity 1.00; specificity 0.63). Regression analysis showed that NIRS rSO2 score is complementary to the SAFIRE grade.ConclusionsNIRS rSO2 monitoring in patients with SAH may improve prediction of DCI and clinical outcome after SAH.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

8 keywords...

hide…