title: Clinical features of subarachnoid hemorrhage in patients with positive cancer history.
abstract: Advances in cancer treatment have dramatically increased long-term survivors. Prolonged survival increases comorbidity risk, but there is a paucity of studies on how cancer history alters clinical outcomes from subsequent diseases. This study aims to investigate whether positive cancer history influences clinical outcome following subarachnoid hemorrhage (SAH). We retrospectively reviewed consecutive SAH patients admitted between January 2008 and March 2014. Medical histories, known SAH risk factors, and outcome were compared between SAH patients with and without cancer history. Out of the 498 SAH patients, 55 cases had cancer history, 438 cases had no cancer history and 5 cases had an unknown cancer history. Compared with SAH patients without cancer history, those with cancer history had poorer Hunt & Hess grade at SAH presentation (P = 0.021), and poorer modified Rankin Scale (mRS) score at discharge (P < 0.001). After adjustment for age, sex, modified Fisher, previous SAH, history of hypertension, current smoking status, and current alcohol consumption, positive cancer history remained an independent risk factor for poorer mRS0-6 [odds ratio (OR) = 2.25, 95 % confidence interval (CI) 1.28-3.94] and mRS6 (OR = 2.74, 95 % CI 1.40-5.37). Furthermore, stratified analysis by Hunt & Hess grade adjusted by age, sex, and modified Fisher scale, OR of poorer mRS0-6 was 2.12 (95 % CI 0.89-5.05) and OR of mRS6 was 3.68 (95 % CI 1.35-10.04). After adjustment of patients for demographic factors, classical risk factors for SAH and Hunt & Hess grade, previous cancer history is a risk factor for the poor functional outcome of SAH.
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan. shibahar@nsg.med.tohoku.ac.jp.
authors.forename: Ichiyo
authors.initials: I
authors.lastname: Shibahara
authors.affiliation: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ezura
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Fujimura
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kimura
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Suzuki
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Nishino
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Shinjitsu
authors.initials: S
authors.lastname: Nishimura
authors.affiliation: Department of Neurosurgery, National Hospital Organization Sendai Medical Center, 2-8-8 Miyagino Miyagino-ku, Sendai, 983-8520, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uenohara
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000368:Aged; D000073116:Cancer Survivors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Aneurysm; Cancer; Outcome; Poor grade; Subarachnoid hemorrhage