title: Impact of Comorbidity on Early Outcome of Patients with Subarachnoid Hemorrhage Caused by Cerebral Aneurysm Rupture.
abstract: BACKGROUND
  One of the complications aneurysms subarachnoid hemorrhage is the development of vasospasm, which is the leading cause of disability and death from ruptured cerebral aneurysm.
  
  
  OBJECTIVE
  To evaluate the significance of previous comorbidities on early outcome of patients with subarachnoid hemorrhage caused by rupture of a cerebral aneurysm in the prevention of vasospasm.
  
  
  METHODS
  The study had prospective character in which included 50 patients, whose diagnosed with SAH caused by the rupture of a brain aneurysm in the period from 2011to 2013. Two groups of patients were formed. Group I: patients in addition to the standard initial treatment and "3H therapy" administered nimodipine at a dose of 15-30 mg / kg bw / h (3-10 ml) for the duration of the initial treatment. Group II: patients in addition to the standard initial treatment and "3H therapy" administered with MgSO4 at a dose of 12 grams in 500 ml of 0.9% NaCl / 24 h during the initial treatment.
  
  
  RESULTS
  Two-thirds of the patients (68%) from both groups had a good outcome measured with values according to GOS scales, GOS IV and V. The poorer outcome, GOS III had 20% patients, the GOS II was at 2% and GOS I within 10% of patients. If we analyze the impact of comorbidity on the outcome, it shows that there is a significant relationship between the presence of comorbidity and outcomes. The patients without comorbidity (83.30%) had a good outcome (GOS IV and V), the same outcome was observed (59.4%) with comorbidities, which has a statistically significant difference (p = 0.04). Patients without diabetes (32%) had a good outcome (GOS IV and V), while the percentage of patients with diabetes less frequent (2%) with a good outcome, a statistically significant difference (p = 0.009).
  
  
  CONCLUSIONS
  The outcome of treatment 30 days after the subarachnoid hemorrhage analyzed values WFNS and GOS, is not dependent on the method of prevention and treatment of vasospasm. Most concomitant diseases in patients with SAH which, requiring additional treatment measures are arterial hypertension and diabetes mellitus. The best predictors in the initial treatment of patients with subarachnoid hemorrhage caused by rupture of a cerebral aneurysm has the presence of comorbidity, which has statistical significance.
authors.affiliation: Clinic for Anesthesiology and Reanimatology, University Clinical Center Tuzla, Tuzla, Bosna i Hercegovina.
authors.forename: Selma Sijercic
authors.initials: SS
authors.lastname: Avdagic
authors.affiliation: Clinic for Anesthesiology and Reanimatology, University Clinical Center Tuzla, Tuzla, Bosna i Hercegovina.
authors.forename: Harun
authors.initials: H
authors.lastname: Brkic
authors.affiliation: Clinic for Neurosurgery, University Clinical Center Tuzla, Tuzla, Bosna i Hercegovina.
authors.forename: Harun
authors.initials: H
authors.lastname: Avdagic
authors.affiliation: Clinic for Neurosurgery, University Clinical Center Tuzla, Tuzla, Bosna i Hercegovina.
authors.forename: Jasmina
authors.initials: J
authors.lastname: Smajic
authors.affiliation: Clinic for Cardiovascular Desease, University Clinical Center Tuzla, Tuzla, Bosna i Hercegovina.
authors.forename: Samir
authors.initials: S
authors.lastname: Hodzic
mesh_terms: D015897:Comorbidity; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012422:Rupture, Spontaneous; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome
keywords: comorbidity; subarachnoid hemorrhage; vasospasm