Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis
Background The outcome of diffuse angiogram‐negative subarachnoid hemorrhage (dan‐SAH) compared with aneurysmal SAH (aSAH) remains unclear. This study aimed to compare outcomes using propensity score matching. Methods and Results Sixty‐five patients with dan‐SAH and 857 patients with aSAH admitted b...
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.031066 |
| _version_ | 1797229328844455936 |
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| author | Guang‐Dong Lu Cheng Wang Lin‐Bo Zhao Hai‐Bin Shi Sheng Liu |
| author_facet | Guang‐Dong Lu Cheng Wang Lin‐Bo Zhao Hai‐Bin Shi Sheng Liu |
| author_sort | Guang‐Dong Lu |
| collection | DOAJ |
| description | Background The outcome of diffuse angiogram‐negative subarachnoid hemorrhage (dan‐SAH) compared with aneurysmal SAH (aSAH) remains unclear. This study aimed to compare outcomes using propensity score matching. Methods and Results Sixty‐five patients with dan‐SAH and 857 patients with aSAH admitted between January 2018 and December 2022 were retrospectively reviewed. Propensity score matching resulted in matching 65 patients with dan‐SAH to 260 patients with aSAH, and clinical outcomes were compared between the groups. Compared with patients with dan‐SAH, patients with aSAH were more likely to experience rehemorrhage (8.8% versus 0%, P=0.027), death (11.2% versus 1.5%; odds ratios [OR] 8.04 [95% CI, 1.07–60.12]; P=0.042), or delayed cerebral ischemia (12.3% versus 3.1%; OR, 4.42 [95% CI, 1.03–18.95]; P=0.045). Multivariate analysis revealed that Hunt–Hess grade 4 to 5 (OR, 3.13 [95% CI, 2.11–4.64]; P<0.001), presence of intraventricular hemorrhage (OR, 3.58 [95% CI, 1.72–7.46]; P=0.001), and smoking (OR, 2.44 [95% CI, 1.12–5.28]; P=0.024) were independently associated with the incidence of unfavorable outcomes (modified Rankin scale score >2 at 3 months), whereas dan‐SAH was not (OR, 0.66 [95% CI, 0.25–1.73]; P=0.40). Conclusions Compared with patients with dan‐SAH, patients with aSAH had higher rehemorrhage rates and in‐hospital mortality, as well as a higher incidence of delayed cerebral ischemia. Unfavorable outcomes were associated with admission Hunt–Hess grade, the presence of intravenetricular hemorrhage, and smoking history, but there was no relation with the pathogenesis of the hemorrhage (dan‐SAH versus aSAH). |
| first_indexed | 2024-03-08T13:50:29Z |
| format | Article |
| id | doaj.art-9e0277a418fc4752bc14fcbcd49c40f0 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:51Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-9e0277a418fc4752bc14fcbcd49c40f02024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.031066Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched AnalysisGuang‐Dong Lu0Cheng Wang1Lin‐Bo Zhao2Hai‐Bin Shi3Sheng Liu4Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu ChinaDepartment of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu ChinaBackground The outcome of diffuse angiogram‐negative subarachnoid hemorrhage (dan‐SAH) compared with aneurysmal SAH (aSAH) remains unclear. This study aimed to compare outcomes using propensity score matching. Methods and Results Sixty‐five patients with dan‐SAH and 857 patients with aSAH admitted between January 2018 and December 2022 were retrospectively reviewed. Propensity score matching resulted in matching 65 patients with dan‐SAH to 260 patients with aSAH, and clinical outcomes were compared between the groups. Compared with patients with dan‐SAH, patients with aSAH were more likely to experience rehemorrhage (8.8% versus 0%, P=0.027), death (11.2% versus 1.5%; odds ratios [OR] 8.04 [95% CI, 1.07–60.12]; P=0.042), or delayed cerebral ischemia (12.3% versus 3.1%; OR, 4.42 [95% CI, 1.03–18.95]; P=0.045). Multivariate analysis revealed that Hunt–Hess grade 4 to 5 (OR, 3.13 [95% CI, 2.11–4.64]; P<0.001), presence of intraventricular hemorrhage (OR, 3.58 [95% CI, 1.72–7.46]; P=0.001), and smoking (OR, 2.44 [95% CI, 1.12–5.28]; P=0.024) were independently associated with the incidence of unfavorable outcomes (modified Rankin scale score >2 at 3 months), whereas dan‐SAH was not (OR, 0.66 [95% CI, 0.25–1.73]; P=0.40). Conclusions Compared with patients with dan‐SAH, patients with aSAH had higher rehemorrhage rates and in‐hospital mortality, as well as a higher incidence of delayed cerebral ischemia. Unfavorable outcomes were associated with admission Hunt–Hess grade, the presence of intravenetricular hemorrhage, and smoking history, but there was no relation with the pathogenesis of the hemorrhage (dan‐SAH versus aSAH).https://www.ahajournals.org/doi/10.1161/JAHA.123.031066aneurysmal subarachnoid hemorrhageclinical outcomediffuse angiogram‐negative subarachnoid hemorrhagepropensity score matching |
| spellingShingle | Guang‐Dong Lu Cheng Wang Lin‐Bo Zhao Hai‐Bin Shi Sheng Liu Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aneurysmal subarachnoid hemorrhage clinical outcome diffuse angiogram‐negative subarachnoid hemorrhage propensity score matching |
| title | Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis |
| title_full | Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis |
| title_fullStr | Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis |
| title_full_unstemmed | Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis |
| title_short | Clinical Outcomes of Diffuse Angiogram‐Negative Subarachnoid Hemorrhage Versus Aneurysmal Subarachnoid Hemorrhage: A Propensity Score‐Matched Analysis |
| title_sort | clinical outcomes of diffuse angiogram negative subarachnoid hemorrhage versus aneurysmal subarachnoid hemorrhage a propensity score matched analysis |
| topic | aneurysmal subarachnoid hemorrhage clinical outcome diffuse angiogram‐negative subarachnoid hemorrhage propensity score matching |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.031066 |
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