Abstract Details

Title Delirium and Older Age: Two Independent Predictors of Worse Outcome in Low-intermediate Grade Subarachnoid Hemorrhage

Topic Neuro Trauma and Critical Care

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 364

Objective

To determine worse prognostic factors in low-intermediate grade aneurysmal subarachnoid hemorrhage (aSAH) patients.

Background

Low-intermediate grade aSAH is not always associated with favorable outcomes, making neurocritical care admission with prolonged hospital courses usually required.

Design/Methods We performed a retrospective cohort study of consecutive patients admitted for aSAH to a referral academic center from 2016 to 2021. Patients with Hunt and Hess (HH) grades of 1 to 3 were included. Univariate and binary logistic regression analyses were used to test the association of worse outcome (defined at modified Rankin Scale [mRS] 3-6 at 3 months after discharge) and non-home discharge disposition.

Results Of 151 patients, 77 were HH grades 1-2 and 74 were HH grade 3. As expected, outcome was worse in HH grade 3 than in HH grades 1-2 (mRS median 3, IQR 1-4 vs median 1, IQR 1-3; p<0.001). For HH 1-2, univariate analysis showed early neurological deterioration (OR 3.99, 95% CI 1.38-11.6) and older age (OR 1.07 per year increase, 95% CI 1.03-1.12) were associated with worse outcome. Binary logistic regression after adjustment for baseline mRS, hospital complications and aSAH related factors showed only age (OR 1.1 per year increase, 95% CI 1.02-1.19; OR 1.09 per year increase, 95% CI 1.001-1.18) remained significant. For HH grade 3, binary logistic regression showed older age (OR 1.05 per year increase, 95% CI 1.003-1.10) and delirium (OR 9.18, 95% CI 1.8-47.2) were independently associated with worse outcome after adjustment for baseline mRS, modified Fisher scale and aSAH related complications.

Conclusions

Older age and delirium appear to be independently associated with worse outcome in low-intermediate grade aSAH patients. These findings may help design future studies for risk stratification to tailor monitoring and optimize use of resources in these patients.

Authors/Disclosures
PRESENTER	No disclosure on file
Liqi Shu, MD (Brown Neurology)	Dr. Shu has nothing to disclose.
Linda C. Wendell, MD, FAAN (Mount Auburn Hospital)	Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. An immediate family member of Dr. Wendell has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Wendell has stock in Apple. An immediate family member of Dr. Wendell has stock in Apple.
Bradford B. Thompson, MD (St. Elizabeth’s Medical Center)	Dr. Thompson has nothing to disclose.
Karen L. Furie, MD (RIH/Alpert Medical School of Brown Univ)	The institution of Dr. Furie has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Janssen/BMS. Dr. Furie has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for BMJ/JNNP. The institution of Dr. Furie has received research support from NINDS.
Jesse Menville	Ms. Menville has nothing to disclose.
Ali Mahta, MD (Brown University)	Dr. Mahta has received research support from Brown University Health.

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