Sodium Variability and Probability of Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage.
Sodium Variability and Probability of Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage.
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DOI：
10.1016/j.jstrokecerebrovasdis.2021.106186
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发表时间：
2022-01
影响因子：
2.5
通讯作者：
Thomas, Ajith J.
中科院分区：
文献类型：
--
作者：
Chua, Melissa M. J.;Enriquez-Marulanda, Alejandro;Gomez-Paz, Santiago;Akamatsu, Yosuke;Salem, Mohamed M.;Maragkos, Georgios A.;Ascanio, Luis C.;Hanafy, Khalid A.;Fehnel, Corey R.;Ogilvy, Christopher S.;Moore, Justin;Thomas, Ajith J.
血管痉挛是动脉瘤性蛛网膜下腔出血 (aSAH) 的一种众所周知的并发症，通常发生在出血后 4-14 天。根据美国心脏协会的指导方针，目前的理解是低钠血症可能会导致血管痉挛。因此，我们试图确定 aSAH 患者的重复血清钠水平及其与放射学血管痉挛之间的关联。对 2007 年至 2016 年 aSAH 患者进行单中心回顾性分析。记录每日血清钠水平直至入院后第 14 天。低钠血症定义为血清钠值<135 mEq/L。我们评估了其与放射学血管痉挛、神经功能恶化、出院时功能状态和死亡率的关系。使用混合效应回归模型进行重复测量分析，以评估血清钠趋势和结果之间的个体间关系。总共包括 271 名 aSAH 患者。使用混合效应回归模型，随着时间的推移，个体间血清钠值以及放射线血管痉挛、神经功能恶化、功能或死亡结果的发生率没有显着差异（分别为 p = .59、p = .42、p = .94、p = .99）。然而，神经功能恶化、功能结果不佳 (mRS 3-6) 和死亡率较高的患者的总体平均血清钠水平显着较高。血清钠水平变化与 aSAH 患者随后发生的脑血管痉挛无关。这些发现表明血清钠可能对血管痉挛没有影响，避免高钠血症可能对神经、功能和生存有益。
Vasospasm is a well-known complication of aneurysmal subarachnoid hemorrhage (aSAH) that generally occurs 4–14 days post-hemorrhage. Based on American Heart Association guidelines, the current understanding is that hyponatremic episodes may lead to vasospasm. Therefore, we sought to determine the association between repeated serum sodium levels of aSAH patients and its relationship to radiographic vasospasm. A single-center retrospective analysis from 2007–2016 was conducted of aSAH patients. Daily serum sodium levels were recorded up to day 14 post-admission. Hyponatremia was defined as a serum sodium value of < 135 mEq/L. We evaluated the relationship to radiologic vasospasm, neurologic deterioration, functional status at discharge, and mortality. A repeated measures analysis using a mixed-effect regression model was performed to assess the interindividual relationship between serum sodium trends and outcomes. A total of 271 aSAH patients were included. There were no significant differences in interindividual serum sodium values over time and occurrence of radiographic vasospasm, neurologic deterioration, functional, or mortality outcomes (p = .59, p = .42, p = .94, p = .99, respectively) using the mixed-effect regression model. However, overall mean serum sodium levels were significantly higher in patients who had neurologic deterioration, poor functional outcome (mRS 3–6), and mortality. Serum sodium level variations are not associated with subsequent development of cerebral vasospasm in aSAH patients. These findings indicate that serum sodium may not have an impact on vasospasm, and avoiding hypernatremia may provide a neurologic, functional and survival benefit.
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DOI：
10.1016/j.inat.2020.100843
发表时间：
2020-12-01
影响因子：
0.4
作者：
Alabbas, Faisal;Hadhiah, Kawther;Al-Qahtani, Shaya Yaanallah
通讯作者：
Al-Qahtani, Shaya Yaanallah
影响因子：
2
作者：
Kieninger, Martin;Kerscher, Christina;Schebesch, Karl-Michael
通讯作者：
Schebesch, Karl-Michael
影响因子：
8.3
作者：
Al-Rawi, Pippa G.;Tseng, Ming-Yuan;Kirkpatrick, Peter J.
通讯作者：
Kirkpatrick, Peter J.
影响因子：
3.1
作者：
Okazaki, Tomoya;Hifumi, Toru;Kuroda, Yasuhiro
通讯作者：
Kuroda, Yasuhiro
影响因子：
8.3
作者：
Connolly, E. Sander, Jr.;Rabinstein, Alejandro A.;Vespa, Paul
通讯作者：
Vespa, Paul