Subarachnoid Hemorrhage from Ruptured Aneurysm in Sawanpracharak Hospital
Nrongpong Lowprukmanee MD*
Affiliation : * Department of Surgery, Sawanpracharak Hospital, Nakhonsawan, Thailand
Objective : To study the relationship of factors associated with clinical outcome in surgical groups of aneurysmal subarachnoid
hemorrhage patients (SAH).
Material and Method: The data were retrospectively collected from surgically treated SAH patients who had surgery at
Sawanpracharak Hospital between January 2007 and March 2016. The following risk factors were studied: hypertension,
diabetes mellitus, hyperlipidemia, heart disease, previous stroke, family history of stroke, hematologic disease, history of
medication, smoking, alcoholic consumption, obesity, Glasgow Coma Scale, doll’s eye reflex, pupillary examination, size
of aneurysm, midline shift, intraventricular bleeding, subdural hematoma, hydrocephalus, convulsion, pneumonia, rebleeding,
vasospasm, postoperative brain edema, postoperative brain infarction, intraoperative aneurysm rupture, bacterial meningitis,
location of aneurysm, ventriculoperitoneal (VP) shunt, ventriculostomy, tracheostomy, time to surgery, hospital stay, operating
time, and intraoperative blood loss.
Results : One hundred sixty five patients with SAH underwent surgical treatment. Factors that were statistically significant
related to outcome of SAH were postoperative brain edema [OR 3.79 (1.35 to 10.69), p = 0.01], intraoperative rupture [OR
2.59 (1.16 to 5.80), p = 0.02], MCA aneurysm [OR 0.23 (0.08 to 0.69), p = 0.05], ventriculostomy [OR 3.04 (1.32 to 6.99),
p = 0.009], VP shunt [OR 0.08 (0.01 to 0.74), p = 0.026], and doll’s eye reflex [OR 0.14 (0.03 to 0.47), p = 0.002].
Conclusion : Outcome of surgical treatment of SAH were related to postoperative brain edema, intraoperative rupture,
MCA aneurysm, ventriculostomy, VP shunt, and doll’s eye reflex.
Keywords : Aneurysmal subarachnoid hemorrhage, Glasgow Coma Scale, Intraventricular bleeding, Hydrocephalus, Glasgow Outcome Scale
