Incidence of complications in patients with spontaneous subarachnoid hemorrhage.

Incidence of complications in patients with spontaneous subarachnoid hemorrhage.

Main Article Content

Mercedes Soledad Corona Fonseca
Ada Sánchez Lozano
Ernesto Castro López
Luis Alberto Corona Martínez

Abstract

The occurrence of complications affects the evolution and darkens the prognosis of patients with spontaneous subarachnoid hemorrhage. The objective was to determine the incidence of neurological and non-neurological complications in a series of patients with spontaneous subarachnoid hemorrhage. An observational, descriptive-correlational and retrospective study of 96 patients with spontaneous subarachnoid hemorrhage between 2016 and 2021 was carried out. The frequency of different neurological and non-neurological complications was determined, as well as the relationship between the presence of neurological complications and other variables through analysis. bivariate (Odds Ratio and its confidence interval). Among the results it is found that 53% of the patients presented some type of neurological complication, which prevailed in those 60 years of age or older (62% vs 45%), in aneurysmal etiology (54% vs 27%) and when the diagnosis was made. in the first 48 hours of the onset of symptoms (56% vs 43%). The frequency of complicated patients increased from grade I to grade V on the Hunt and Hess scale (OR 30.6[8.2;113]), the same as on the Fisher scale (OR 11.6[3 ,1;43,2]). The most frequent neurological complication was intracranial hypertension (39%), while the non-neurological one was pneumonia (24%). It is concluded that the series of patients was characterized by a high frequency of neurological complications, among which intracranial hypertension predominated. An evident relationship was demonstrated between the worst grades on the Hunt and Hess and Fisher imaging scales, obtained in the patient's assessment on admission, and the higher incidence of neurological complications.

References

Abraham, M.K., & Chang, W.W. (2016). Subarachnoid Hemorrhage. Emerg Med Clin North Am., 34(4):901‐16. Disponible en: https://doi.org/10.1016/j.emc.2016.06.011

Argüeso García, M., & Mesejo Arizmendi, A. (2015). Pronóstico de la hemorragia subaracnoidea espontánea aneurismática y su correlación con escalas de gravedad, escalas de calidad de vida y tratamiento endovascular [Tesis]. Universidad de Valencia, Departamento de Medicina. 2015. Disponible en: http://roderic.uv.es/bitstream/handle/10550/50503/TESIS%20DOCTORAL%20MONICA%20ARGUESO%20GARCIA.pdf?sequence=2&isAllowed=y

Brenes Zumbado, M.J., Romero Castillo, A., & Jiménez Víquez, M. (2020). Abordaje de hemorragia subaracnoidea. Rev Méd Sinerg., 5(10):e589. Disponible en: https://doi.org/10.31434/rms.v5i10.589

Cárdenas Alvarado, K.S., Guerra Ayala, B.R., Gil Vargas, A.G., & Morales Guaminga, J.K. (2020). Complicaciones de la Hemorragia Subaracnoidea Aneurismática. Sinergias Educativas., E(Especial 1);1-7. Disponible en: http://www.redalyc.org/articulo.oa?id=573561701005

Chen, S., Luo, J., Reis, C., Manaenko, A., & Zhang, J. (2017). Hydrocephalus after subarachnoid hemorrhage: Pathophysiology, diagnosis, and treatment. Biomed Res Int., 85(8):47-53. Disponible en: https://doi.org/10.1155/2017/8584753

D’Souza, S. (2015). Aneurysmal Subarachnoid Hemorrhage. J Neurosurg Anesthesiol., 27(3):222-40. doi:10.1097/ANA.0000000000000130. Disponible en: http://www.revneuro.sld.cu/index.php/neu/article/view/18

Dority, J.S., & Oldham, J.S. (2016). Subarachnoid Hemorrhage. An Update. Anesthesiology Clinics., 34(3):577-600. Disponible en: https://doi.org/10.1016/j.anclin.2016.04.009

Etminan, N., & McDonald, R.L. (2017). Management of aneurysmal subarachnoid hemorrhage. Handb Clin Neurol., 140:195‐228. doi:10.1016/B978-0-444-63600-3.00012-X

Galofre Martínez, M., Ordosgoitia Morales, J., Ripoll Zapata, V., Morales Núñez, M., Corrales

Santander, H., & Moscote Salazar, L. (2020). Manejo neurointensivo de la hemorragia subaracnoidea aneurismática. Revista Cubana de Medicina Intensiva y Emergencias.,19(3):e523. Disponible en: http://www.revmie.sld.cu/index.php/mie/article/view/523

González Aguirre, Y., Varela Hernández, A., Casares Albernas, F., Herrera Lorenzo, O., Infante Ferrer, J., & Morgado Castañeda, R. (2012). Comportamiento de la hemorragia subaracnoidea espontánea en el Hospital Universitario “Manuel Ascunce Domenéch”. Rev Cubana Neurol Neurocir., 2(1):17-22. Disponible en: https://www.medigraphic.com/pdfs/revcubneuro/cnn-2012/cnn121d.pdf

Green, D.M., Burns, J.D., & DeFusco, C.M. (2013). ICU management of aneurysmal subarachnoid hemorrhage. J Intensive Care Med., 28(6):341‐54. doi:10.1177/0885066611434100

Guanoquiza Fares, E.P., Jiménez, J., & Flores, E.L. (2020) Modelo de conservación de levine en el cuidado del paciente con hemorragia subaracnoidea aneurismática Fisher grado IV (trabajo de titulación). UTMACH, Facultad de ciencias Químicas y de la Salud, Machala, Ecuador. 87 p. disponible en: http://repositorio.utmachala.edu.ec/handle/48000/15804

Hoyos Castillo, J.D., & Moscote Salazar, L.R. (2016). Hemorragia subaracnoidea aneurismática con mal grado clínico: Revisión clínica. Revista Mexicana Neurociencia., 17(1):50-64. Disponible en: https://www.medigraphic.com/pdfs/revmexneu/rmn-2016/rmn161f.pdf

Huidobro Salazar, J.F., & Quintana Marin, L. (2017). Guia clínica para el manejo de la hemorragia subaracnoidea aneurismática: propuesta de actualización al Ministerio de Salud de Chile. Rev Chil de Neurocir., 43(2):156-65. Disponble en: https://doi.org/10.36593/rev.chil.neurocir.v43i2.79

Illicachi Rojas, N.J., López Pérez, J.C., & Gaibor Vásconez, M.R. (2020). Manejo de hemorragia subaracnoidea en el servicio de emergencia. Hospital Carlos Andrade Marín. Quito, 2019 [Tesis]. Facultad de Ciencias de la Salud: Universidad Nacional de Chimborazo. Disponible en: http://dspace.unach.edu.ec/handle/51000/6723

Kanat, A. (2014). Pathophysiology of Acute Hydrocephalus After Subarachnoid Hemorrhage. World Neurosurgery., 82(1-2):e386-7. Disponible en: https://doi.org/10.1016/j.wneu.2013.08.007

Lelubre, C., Bouzat, P., Crippa, I.A., & Taccone, F.S. (2016). Anemia management after acute brain injury. Critical Care., 20(152). https://doi.org/10.1186/s13054-016-1321-6

Lin, B.F., Kuo, C.Y., & Wu, Z.F. (2014). Review of aneurysmal subarachnoid hemorrhage-focus on treatment, anesthesia, cerebral vasospasm prophylaxis, and therapy. Acta Anaesthesiol Taiwan., 52(2):77‐84. doi:10.1016/j.aat.2014.04.005

Long, B., Koyfman, A., & Runyon, M.S. (2017). Subarachnoid Hemorrhage: Updates in diagnosis and management. Emerg Med Clin N Am., 35(4):803-24. https://doi.org/10.1016/j.emc.2017.07.001

Marcolini, E., & Hine, J. (2019). Approach to the diagnosis and management of subarachnoid hemorrhage. West J Emerg Med., 20(2):203-11. doi:10.5811/westjem.2019.1.37352.

Mavridis, I.N., Meliou, M., & Stylianos Pyrgelis, E. (2015). Troponin elevation in subarachnoid Hemorrhage. Journal Acute Disease., 4(1):7-11. Disponible en: https://doi.org/10.1016/S2221-6189(14)60074-3

McDonald, R.L., & Schweizer, T.A. (2017). Spontaneous subarachnoid haemorrhage. Lancet., 389(10069):655-66. Disponible en: https://doi.org/10.1016/S0140-6736(16)30668-7

Ministerio de Salud Pública. Anuario estadístico de Salud. (2019). La Habana: Dirección Nacional de Registros Médicos y estadísticas del Minsap. Disponible en: http://bvscuba.sld.cu/anuario-estadistico-de-cuba/

Miranda Hernández, J.L., Pérez Nellar, J., Scherle Matamoros, C., González González, J., & de Jongh Cobo, E., & Hierro García, D. (2014). Atención a pacientes con “grados buenos” de hemorragia subaracnoidea aneurismática en la unidad de ictus. Rev Cubana Med. 2014;53(3):239-53. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232014000300002&lng=es.

Noya Chaveco, M.E., & Moya González, N.L. (2017). Parte XII. Enfermedades del sistema nervioso. Capítulo 104. Enfermedades cerebrovasculares.

Roca Goderich. Temas de Medicina Interna. Tomo II. Quinta edición. 5 ed. La Habana, CU: ECIMED. Disponible en: http://bvs.sld.cu/libros_texto/ roca_temas_medicina_interna_tomo2_quintaedicion/ cap104.pdf

Nyquist, P., Jichici, D., Bautista, C., Burns, J., Chhangani, S., DeFilippis, M., D Goldenberg, F.,

Kim, K., Liu DeRke, X., Mack, W., & Meyer, K. (2017). Prophylaxis of Venous Thrombosis in Neurocritical Care Patients: An Executive Summary of Evidence-Based Guidelines: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Crit Care Med., 45(3):476-9. doi:10.1097/CCM.0000000000002247.

Pérez Nellar, J., Scherle Matamoros, C., Gil Alfonso, M., González González, J., & Hierro García, D. (2014). Hemorragia subaracnoidea no aneurismática. Rev Cubana Med., 53(3):310-24. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75232014000300008&lng=es.

Petridis, A.K., Kamp, M.A., Cornelius, J.F., Beez, T., Beseoglu, K., Turowski, B., & Steiger, H.J. (2017). Aneurysmal subarachnoid hemorrhage. Dtsch Arztebl Int., 114:226-36. doi:10.3238/arztebl.2017.0226.

Rabinstein, A.A., & Lanzino, G. (2018). Aneurysmal subarachnoid hemorrhage: Unanswered questions. Neurosurg Clin N Am., 29(2): 255-62. doi: 10.1016/j.nec.2018.01.001.

Raya, A.K., & Diringer, M.N. (2014). Treatment of subarachnoid hemorrhage. Crit Care Clin., 30(4):719-33. doi: 10.1016/j.ccc.2014.06.004

Rodríguez García, P.L., & Rodríguez García, D. (2011). Hemorragia subaracnoidea: epidemiología, etiología, fisiopatología y diagnóstico. Rev Cubana Neurol Neurocir., 1(1):59–73.

Sabogl Barrios, R., Cabrera González, A., De Lima Zea, A., Lambertínez Álvarez, I., Pérez Calvo, C., Pájaro Galvis, N., Buelvas Villalba, M., Rico

Fontalvo, J., Daza Arnedo, R., & Vergara Serpa, Ó. (2020). Hemorragia Subaracnoidea Aneurismática..Archivos de medicina., 16(6):1-11. doi: 10.3823/1455

Santamaría Cadavid, M., Arias Rivas, S., & Rodríguez Yánez, M. (2019). Hemorragia Subaracnoidea. Malformaciones arteriovenosas. Medicine., 12(70):4097-107. Disponible en: https://doi.org/10.1016/j.med.2019.01.003

Sarduy Ramos, C.M., Betancourt Betancourt, G., Escobar Alfonso, V., & Millares Díaz, M.C. (2006). Utilidad pronóstica de la ecografía doppler transcraneal en el vasoespasmo asociado a hemorragia subaracnoidea espontánea. AMC.,10(5):81-92. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552006000500010&lng=pt

Tan, Q., Chen, Q., Feng, Z., Shi, X., Tang, J., Tao, Y., Jiang, B., Tan, L., Feng, H., Zhu, G., Yang, Y., & Chen, Z. (2017). Cannabinoid receptor 2 activation restricts fibrosis and alleviates hydrocephalus after intraventricular hemorrhage. Brain Research.,1654:24-33. Disponible en: https://doi.org/10.1016/j.brainres.2016.10.016.

Valverde Naranjo, M. (2016). Hemorragia Subaracnoidea. Rev Med Costa Rica LXXIII., 73(619)221-226. Disponible en: https://www.binasss.sa.cr/revistas/rmcc/619/art05.pdf

Yolas, C., Ozdemir, N.G., Kanat, A., Aydin, M.D., Keles, P., & Kepoglu, U. (2016). Uncovering a New Cause of Obstructive Hydrocephalus Following Subarachnoid Hemorrhage: Choroidal Artery Vasospasm–Related Ependymal Cell Degeneration and Aqueductal Stenosis—First Experimental Study. World Neurosurgery., 90:484-91. Disponible en: https://doi.org/10.1016/j.wneu.2016.03.049

Yunga Bravo, G.F., Machuca Córdova, L.M., Yunga Bravo, M.P., & Cuenca Romero, R.C. (2020). Actuación clínica en la hemorragia subaracnoidea. RECIMUNDO., 4(1(Esp):256-67. Disponible en: http://r