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KMID : 0359819960250051036
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Journal of Korean Neurosurgical Society
1996 Volume.25 No. 5 p.1036 ~ p.1046
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Causes of Mortality in Spontaneous Subarachnoid Hemorrhage
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배학근
도재원/이경석/윤일규/변박장
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Abstract
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To investigate the causes of death in patients with spontaneous subarachnoid hemorrhage. 460 consecutive patients with a subarachnoid hemorrhage were reviewed Angiography was not performed in 78 patients due to poor clinical conditions or
discharge
against admission. Of all these patients. 54 (69.2%) died. 28 from serious clinical condition. 21 from rebleeding. 3 from pulmonary complications 1 from vasospasm. and 1 with unknown causes. Thirty eight patients were angiographically negative.
of
which
6 (15.8%) died. 3 due to rebleeding. 2 due to poor clinical condition. and 1 due to cerebral infarction caused by vasospasm. Of the 344 patients who had an aneurysmal subarachnoid hemorrhage. 74 were discharged against . admission or died before
the
surgery. The remaining 270 patients underwent aneurysm olipping. Early surgery (within 72 hours after subarachnoid hemorrhage) was performed in 151 patients. intermediate surgery (between Day 4 and 7 post SAH) in 74 and late surgery (Day 8 or
later
after SAH) in 45 Fifty-one patients (18.9%) died after aneurysm clipping The causes were vasospasm in 17 complications related to surgery in 13. poor clinical condition in 12 preoperative rebleeding in 7 and other systemic condition in 2. A total
of 59
patients suffered at least one rebleeding after the initial hemorrhage : these patients had a mortality rate of 76.3% and the highest rate of rebleeding occurred within the first 24 hours after initial hemorrhage. Vasospasm and rebleeding were
the
leading causes of mortality in addition to the initial bleeding. Predictors for mortality included poor clinical grade early surgery in patients aged 60 years or more and association with intracerebral hematoma intraventricular hemorrhage. or
subdural
hematoma.
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KEYWORD
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