Predictive factors of death in patients with spontaneous subarachnoid hemorrhage

Abstract

The study aimed to determine the predictors of death (in the first 21 days) in patients with spontaneous subarachnoid hemorrhage; for this, an observational, descriptive-correlational study was carried out, which included 79 patients with spontaneous subarachnoid hemorrhage between 2016 and 2021. Fatality due to the disease and its relationship with various variables were determined, for which bivariate and multivariate analysis (logistic regression) was performed; The Odds Ratio and its confidence interval were used as statisticians. Among the main results are the following: 29 patients (36.7%) died. Mortality was higher in older adults (40% vs 33%, not significant), in females (43% vs 29%, not significant) and in patients admitted within the first 48 hours of diagnosis (43% vs 7%, OR 9.8[1.2;79.7]); also in whom the cause of the bleeding could not be identified (64%), and in the clinical presentation with a predominance of alterations in the state of consciousness (OR 3.3[1.03;10.5]). In the clinical and imaging scales used, a progressive increase in lethality from low to high grades was found (Hunt and Hess: OR 13.6[4.3;43.2]; Fisher: OR 14.4[1.8;115.3]). As conclusions of the investigation, the lethality at 21 days in the series studied is considered high, and was associated with the clinical presentation with a predominance of alterations in the state of consciousness, the greater intensity of the initial bleeding (Fisher IIIIV), the occurrence of neurological complications and the superimposed respiratory infection. The importance of rebleeding in the occurrence of death is verified, as well as the condition of death predictor of the Hunt and Hess scale.