Significance of loss of consciousness at onset of subarachnoid hemorrhage

• 出 处: 中华物理医学与康复杂志
• 发表日期: 2016年38期

BACKGROUND AND OBJECTIVE

Subarachnoid hemorrhage (SAH) commonly presents with a loss of consciousness (LOC). This study was designed to further understand the significance of LOC at the onset of SAH.

METHODS

This retrospective analysis included data from 1，482, consecutively treated patients with SAH. Those admitted to Columbia Presbyterian Hospital within 14 days of hemorrhage were included. LOC was determined by interview with patients, families and first responders. Patient records were assessed for in-hospital mortality, and for outcomes after discharge, including modified Rankin scale (mRS) scores at three and 12 months, as well as hospital complications.

RESULTS

Of the 1，482 patients enrolled in the outcome study, 590 were noted to have LOC at onset of SAH. Compared to those who did not lose consciousness, those with LOC had more cisternal and intraventricular blood on CT scan, as well as global cerebral edema, parenchymal hematoma, hydrocephalus and acute infarction. Patients with LOC were also more likely to have an aneurysm coiled rather than clipped. At 12 months, 51.2% of patients with LOC were dead or severely disabled, as compared with 17.7% of those without LOC (P<0.001). LOC was significantly related to functional outcome at 12 months (P＝0.003).

CONCLUSION

This study of patients with subarachnoid hemorrhage found that loss of consciousness at onset is a robust indicator of severe bleeding and worse outcome, including death and disability.