title: A Propensity Score-Matched Study of the Use of Non-steroidal Anti-inflammatory Agents Following Aneurysmal Subarachnoid Hemorrhage.
abstract: Inflammation may contribute to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH). Here, we compared outcomes among propensity score-matched cohorts who did and did not receive non-steroidal anti-inflammatory drug (NSAID) use after aSAH.
  
  
  
  Propensity score-matched analysis of 413 subjects enrolled in the Clazosentan to Overcome Neurological iSChemia and Infarction OccUring after Subarachnoid hemorrhage (CONSCIOUS-1) study. Propensity score matching was performed on the basis of age, sex, baseline National Institutes of Health Stroke Scale score, World Federation of Neurological Societies grade on admission, procedure used for securing aneurysm, and SAH clot burden.
  
  
  
  178 patients were matched (89 received NSAIDs, 89 did not). Propensity score matching was considered acceptable. Patients who had received NSAIDs during their hospital stay had significantly lower mortality rate, and reduced duration of intensive care unit stay and total length of hospital stay (P = 0.035, P = 0.009, and P = 0.053, respectively). At 6 weeks, 80.9 % of patients treated with NSAIDs had good functional outcome compared to 68.5 % of matched controls (P = 0.083). There was no significant difference in the proportions of patients who developed delayed ischemic neurological deficits, angiographic vasospasm, or required rescue therapy.
  
  
  
  Inflammation may play a crucial role in the poor outcomes after SAH, and that NSAIDs may be a useful therapeutic option, once validated by larger prospective studies.
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Farshad
authors.initials: F
authors.lastname: Nassiri
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: George M
authors.initials: GM
authors.lastname: Ibrahim
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Jetan H
authors.initials: JH
authors.lastname: Badhiwala
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Witiw
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mansouri
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, ON, Canada.
authors.forename: Naif M
authors.initials: NM
authors.lastname: Alotaibi
authors.affiliation: Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. MacdonaldLo@smh.ca.|Labatt Family Centre of Excellence in Brain Injury and Trauma Research, St. Michael's Hospital, Toronto, Canada. MacdonaldLo@smh.ca.|Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Canada. MacdonaldLo@smh.ca.|Department of Surgery, University of Toronto, Toronto, ON, Canada. MacdonaldLo@smh.ca.
authors.forename: R Loch
authors.initials: RL
authors.lastname: Macdonald
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000494:pharmacology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D057216:Propensity Score; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000188:drug therapy / Q000401:mortality* / Q000628:therapy*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Aneurysm; Critical care; Intensive care; NSAID; Subarachnoid hemorrhage