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Journal of critical care · Feb 2017
Hematologic counts as predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
- Da SilvaIvan Rocha FerreiraIRFUniversidade Federal Fluminense, Niteroi, Brazil; Americas Medical City, Rio de Janeiro, Brazil. Electronic address: ivanuerj@gmail.com., Joao Antonio Gomes, Ari Wachsman, Gabriel Rodriguez de Freitas, and Jose Javier Provencio.
- Universidade Federal Fluminense, Niteroi, Brazil; Americas Medical City, Rio de Janeiro, Brazil. Electronic address: ivanuerj@gmail.com.
- J Crit Care. 2017 Feb 1; 37: 126-129.
PurposeAneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, but currently no single clinical method or ancillary test can reliably predict which subset of patients will develop delayed cerebral ischemia (DCI). The aim of this study was to find hematologic derangements and clinical factors present during the first 7 days after bleeding that could help identify patients at risk for development of DCI.Materials And MethodsDatabank analysis of patients with SAH admitted between 2010 and 2012 in a single center. Data from demographics, imaging, laboratory, and clinical factors were collected. Statistical testing was conducted to test for association to the outcome, and multivariate logistic regression was used to design a predictive model.ResultsOf 55 patients, 14 developed DCI (25%). Anemia and leukocytosis on the third day after bleeding were significantly correlated with the outcome (for anemia: P<.032; confidence interval, 1.12-15.16; odds ratio, 4.12; for leukocytosis: P<.046; confidence interval, 1.03-26.13; odds ratio, 5.18). Anemia and leukocytosis were still statistically significant after adjustment for age, sex, modified Fisher scale, and Hunt-Hess scale.ConclusionThe presence of leukocytosis and anemia during the third day after SAH was statistically correlated with the occurrence of DCI.Copyright © 2016 Elsevier Inc. All rights reserved.
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