Abstract Details

Title A Retrospective Analysis Comparing the Outcomes of Subarachnoid Hemorrhage in Pregnant and Nonpregnant Populations

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P3 - Poster Session 3 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-003

Objective

To explore outcomes of pregnant patients with aneurysmal subarachnoid hemorrhage (aSAH) as compared to their nonpregnant counterparts. Measures of outcomes investigated were mortality, functional outcomes, rates of medical complications, and need for surgical intervention for SAH.

Background aSAH is a life-threatening disease with a female predominance. The increased incidence of aSAH in pregnant women compared to nonpregnant women is well documented. Prior studies have demonstrated that pregnant SAH women had better outcomes compared to nonpregnant counterparts but these studies did not control for SAH severity. Our large retrospective analysis looked at outcomes comparing these groups while controlling for SAH severity.

Design/Methods This retrospective analysis was conducted using the National Inpatient Sample (NIS) database. ICD-9-CM and ICD-10-CM codes were used to query the NIS database to select for patients with aSAH and to determine pregnancy status. Between the years 2012 and 2017, 10,654 female aSAH patients between the ages 15 and 49 were identified. Within this cohort, 604 were pregnant. SAH severity was assessed using the NIS-SSS and functional outcome was assessed dichotomously by the NIS-SOM.

Results Pregnant patients with aSAHs were younger (P <0.01), had lower rates of medical complications (P <0.01), poor functional outcomes (P<0.01) and mortality (P<0.01). Pregnant patients also had lower rates of endovascular coiling (P<0.001), craniotomy clipping (P<0.01) and external ventricular drainage (P<0.001).

Conclusions Outcomes of pregnant versus non-pregnant SAH patients were compared in this retrospective study of the NIS database. When controlled for severity, pregnant aSAH patients were younger, and had lower mortality rates than their non-pregnant counterparts. We suspect that these findings are due to various hemodynamic and hormonal changes that occur during pregnancy, but further investigation should be done to establish the mechanism of the protective effects of pregnancy in these patients.

Authors/Disclosures
Adithya Nagaraja, DO PRESENTER	Dr. Nagaraja has nothing to disclose.
Brittany Russo, MD	Dr. Russo has nothing to disclose.
Ariel Sacknovitz, Medical Student	Mr. Sacknovitz has nothing to disclose.
Martin Kafina, MD (Westchester Medical Center)	Dr. Kafina has nothing to disclose.
Anaz Uddin, MD	Dr. Uddin has nothing to disclose.
Ankita Jain, MS	Miss Jain has nothing to disclose.
Eris Spirollari, BA	Mr. Spirollari has nothing to disclose.
Rasheed Hosein-Woodley	Mr. Hosein-Woodley has nothing to disclose.
Fawaz Al-Mufti, MD (Westchester Medical Center at New York Medical College)	Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .

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