Severe headache trajectory following aneurysmal subarachnoid hemorrhage: the association with lower sodium levels.
Severe headache trajectory following aneurysmal subarachnoid hemorrhage: the association with lower sodium levels.
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DOI：
10.1080/02699052.2022.2055146
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发表时间：
2022-03-21
期刊：
影响因子：
1.9
通讯作者：
Busl, Katharina M.
中科院分区：
文献类型：
--
作者：
Eisinger, Robert S.;Sorrentino, Zachary A.;Lucke-Wold, Brandon;Zhou, Sonya;Barlow, Brooke;Hoh, Brian;Maciel, Carolina B.;Busl, Katharina M.
动脉瘤性SAH （aSAH）的临床特征是头痛。对asah后头痛因素知之甚少，这可能指向潜在的机制。在这项研究中，我们旨在描述与aSAH患者的临床特征相关的头痛的严重程度和发展轨迹。这是一项回顾性纵向研究，研究对象是2012-2019年期间在一家学术三级医疗中心就诊的aSAH成年患者，这些患者可以用语言表达疼痛评分。记录的其他因素包括人口统计学、动脉瘤特征、镇痛、每日早晨血清钠浓度和血管痉挛的发生。采用基于组的轨迹模型识别头痛疼痛轨迹，并比较轨迹之间的临床因素。在91例纳入分析的患者中，平均年龄为57岁，20例（22%）为男性。头痛评分轨迹分为两组：轻度-中度和中度-重度疼痛患者。中重度疼痛组患者比轻中度疼痛组患者更年轻（P<0.05），阿片类镇痛更多（P<0.001），钠浓度更低（P<0.001）。我们确定了两个不同的asah后头痛轨迹队列，并确定了与年龄、镇痛和钠水平的关联。未来的前瞻性研究考虑钠稳态和容量状态下的标准化镇痛方案是必要的。
A clinical hallmark of aneurysmal SAH (aSAH) is headache. Little is known about post-aSAH headache factors, which may point to underlying mechanisms. In this study, we aimed to characterize the severity and trajectory of headaches in relation to clinical features of patients with aSAH. This is a retrospective longitudinal study of adult patients admitted to an academic tertiary care center between 2012–2019 with aSAH who could verbalize pain scores. Additional factors recorded included demographics, aneurysm characteristics, analgesia, daily morning serum sodium concentration, and occurrence of vasospasm. Group-based trajectory modeling was used to identify headache pain trajectories, and clinical factors were compared between trajectories. Of 91 patients included in the analysis, the mean age was 57 years and 20 (22%) were male. Headache score trajectories clustered into two groups: patients with mild-moderate and moderate-severe pain. Patients in the moderate-severe pain group were younger (P<0.05), received more opioid analgesia (P<0.001), and had lower sodium concentrations (P<0.001) than patients in the mild-moderate pain group. We identified two distinct post-aSAH headache pain trajectory cohorts and an association with age, analgesia, and sodium levels was identified. Future prospective studies considering sodium homeostasis and volume status under standardized analgesic regimens are warranted.
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影响因子：
4.9
作者：
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