Prognostic criteria of vasospasm after aneurysmal subarachnoid hemorrhage

Aim: To find the risk factors for vasospasm after aneurysmal subarachnoid hemorrhage Goals: 1. Evaluate frequency of vasospasm of patients with aneurysmal subarachnoid hemorrhage who were treated in Hospital of Lithuanian University of Health Sciences Kauno klinikos Intensive Care Unit of Neurosurgery. 2. Evaluate if age, sex, hypertension, fever, serum sodium level, size and location of ruptured aneurysm are risk factors for vasospasm after aneurysmal subarachnoid hemorrhage. 3. Evaluate if there is correlation between Fisher Scale and cerebral vasospasm 4. Evaluate if patients, who are IV-V grade of World Federation of Neurosurgical Societies (WFNS) are more likely to have cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Methodology: The retrospective analysis of patients who were treated in Hospital of Lithuanian University of Health Sciences Kauno klinikos Intensive Care Unit of Neurosurgery during 2013-2017 years because of aneurysmal subarachnoid hemorrhage was made. Factors analyzed: age, sex, hypertension, smoking, fever, serum sodium level, size and location of ruptured aneurysm, Fisher scale, WFNS scale, Glasgow Outcome scale. IBM SPSS 25.0 was used for statistical data analysis. Results: 138 patients (86 males and 52 females) were included in this study. Mean age of the patients was 55,71 years. Ruptured ACoA aneurysm was found for 48 patients, ACM - 33 patients, ACI - 33 patients, ACA - 10 patients and vertebrobasilar aneurysms 13 patients. Vasospasm was diagnosed for 60(43,47%) patients. There was significant difference between patients with developed vasospasm (59,54 years, SD 14,47; p=0,01) and those whom vasospasm did not develop (50,73metų, SD 15,696; p=0,01). None of the following factors – history of hypertension (p=0,854), smoking (p=0,688), hyponatremia (p=0,152), fever (p=0,456) had no impact on the incidence of vasospasm. Poor grade of WFNS scale (χ2 3,234, p=0,519) or Glasgow outcome scale (χ2 5,27, p=0,261) were not associated with higher risk of cerebral vasospasm. Fisher 3 grade showed association with increased vasospasm risk (χ2 8,308, p=0,04). Conclusions: 1. The incidence of vasospasm was 44,2% 2. Younger age is independent risk factor for cerebral vasospasm. The risk of vasospasm decreases by 4,3% with every year of age. Sex, history of hypertension, fever, hyponatremia, aneurysm localization, were not associated with vasospasm. 3. Fisher 3 grade is independent risk factor for cerebral vasospasm. 4. Patients, who are IV-V grade of World Federation of Neurosurgical Societies were not at higher risk of vasospasm