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- Title
Long-term vascular events after subarachnoid hemorrhage.
- Authors
Fernandez-Perez, Isabel; Giralt-Steinhauer, Eva; Cuadrado-Godia, Elisa; Guimaraens, Leopoldo; Vivas, Elio; Saldaña, Jesus; Suárez-Pérez, Antoni; Macias-Gomez, Adria; Revert-Barbera, Anna; Estragues-Gazquez, Isabel; Rodríguez-Campello, Ana; Jiménez-Balado, Joan; Rey-Álvarez, Lucia; Roquer, Jaume; Jimenez-Conde, Jordi; Ois, Angel
- Abstract
Background: Spontaneous subarachnoid hemorrhage (SAH) long-term risk is not well known. Our aims are: describing long-term vascular event (VE) incidence rates in SAH survivors; describing VE: ischemic and/or hemorrhagic; identifying independent association of factors related to VE; and analyzing the usefulness of factors to increase predictive ability. Methods: A prospective cohort study of consecutive patients admitted to Hospital del Mar with a diagnosis of SAH (n = 566) between January 2007 and January 2020 was carried out. They were followed up until January 2021. The study endpoint was a new VE in the follow-up. We calculated both incidence rates and cumulative rates at 5 years. Cox regression survival models including vascular risk factors with and without specific data of SAH disease were developed. We analyzed ROC curves of all multivariate models. Results: The analyzed cohort included 423 non-fatal SAH cases. Total patient-years were 2468.16 years. The average follow-up was 70.03 ± 43.14; range: 1–180 months. There were 49 VE detected in 47 patients, as 2 of them had more than 1 VE. Incidence rate was 0.020 events_per_patient/year, cumulative incidence at 5 years was 11.11%. The more frequent VE that we found were cerebrovascular (28/49), mainly ischemic (21/28). Disability after SAH and the presence of multiple aneurysms were independently associated with a VE risk and improved the predictive capacity of multivariate models (AUC 0.679 vs 0.764; p = 0.0062). Conclusions: We reported a low vascular risk after SAH. We have shown the usefulness of SAH factors to identify patients with a higher risk of VE.
- Subjects
SUBARACHNOID hemorrhage; CEREBRAL vasospasm; RECEIVER operating characteristic curves; SURVIVAL analysis (Biometry); HOSPITAL patients; REGRESSION analysis
- Publication
Journal of Neurology, 2022, Vol 269, Issue 11, p6036
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-022-11255-z