Cardiac complications after aneurysmal subarachnoid hemorrhage.
BACKGROUND
Cardiac complications are frequently encountered by neurointensivists caring for patients with SAH. Our aim was to better characterize the natural history of various cardiac abnormalities in this population. We sought to determine the risk factors for cardiac abnormalities, patient outcome, and impact of treatment type on cardiac abnormalities.


METHODS
We performed a single center retrospective review of admissions of patients with aneurysmal SAH to the neurosurgical ICU in a large university hospital. Patient demographics, pertinent history, cardiac tests, hospital LOS, intervention type, and discharge outcome were collected.


RESULTS
Data from 266 patients were available for analysis. Of these patients, 50% (n = 133) demonstrated cardiac abnormalities as indicated by abnormal EKG, ECHO, or troponin I. Only age was determined to be an independent statistically significant predictor of cardiac abnormality (P = .01). There was no difference in mortality between the cardiac abnormality and control groups (P = .33). However, there was increased morbidity in the cardiac abnormality group as demonstrated by worse discharge disposition, in addition to increased length of hospital stay (22.6 vs 17.1 days, P < .01). The incidence of cardiac abnormalities was the same among surgical and endovascular treatment groups.


CONCLUSIONS
Cardiac abnormalities, including those that meet ACC criteria for MI, are common among patients with SAH. However, in contrast to cardiac events outside the context of SAH, these abnormalities do not increase mortality. They do, however, adversely affect discharge disposition and prolong hospital LOS. The type of aneurysm treatment does not affect the incidence or outcome of cardiac abnormalities.
Urbaniak
Klaudia
K
Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA.
Merchant
Amina I
AI
Amin-Hanjani
Sepideh
S
Roitberg
Ben
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D004621:Embolization, Therapeutic; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000628:therapy; D016896:Treatment Outcome