Risk Factors for Three Phases of 12-Month Mortality in 1657 Patients from a Defined Population After Acute Aneurysmal Subarachnoid Hemorrhage

Karamanakos, Petros N; Fraunberg, Mikael von und zu; Bendel, Stepani; Huttunen, Terhi; Kurki, Mitja; Hernesniemi, Juha; Ronkainen, Antti; Rinne, Jaakko; Jääskeläinen, Juha E.; Koivisto, Timo

doi:10.1016/j.wneu.2011.08.033

Cited by 59 publications

(46 citation statements)

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“…We considered 12 months as the minimal period for the survivors to recover adequately from their acute and delayed adversities caused by sIA-SAH. 4,5 Long-term sIA-SAH survivors often experience neurological, cognitive, and psychosocial problems 5,12 that may be missed or misinterpreted during their visits to outpatient clinics. Our results help to identify depression in patients surviving sIA-SAH.…”

Section: Strokementioning

confidence: 99%

“…3 Subsequent mortality is high: 22% at 1 month and 27% at 12 months in our series of 1657 patients, mainly because of poor condition and signs of brain injury on admission. 4 Along with various degrees of acute or delayed brain injury, long-term survivors are often affected by neurological and cognitive disorders. 5 Depression after sIA-SAH has been reported in ≤33% of survivors.…”

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confidence: 99%

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Antidepressant Use After Aneurysmal Subarachnoid Hemorrhage

Huttunen

Lindgren

Kurki

et al. 2016

Stroke

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Background and Purpose-To elucidate the predictors of antidepressant use after subarachnoid hemorrhage from saccular intracranial aneurysm (sIA-SAH) in a population-based cohort with matched controls. Methods-The Kuopio sIA database includes all unruptured and ruptured sIA cases admitted to the Kuopio University Hospital from its defined catchment population in Eastern Finland, with 3 matched controls for each patient. The use of all prescribed medicines has been fused from the Finnish national registry of prescribed medicines. In the present study, 2 or more purchases of antidepressant medication indicated antidepressant use. The risk factors of the antidepressant use were analyzed in 940 patients alive 12 months after sIA-SAH, and the classification tree analysis was used to create a predicting model for antidepressant use after sIA-SAH. Results-The 940 12-month survivors of sIA-SAH had significantly more antidepressant use (odds ratio, 2.6; 95% confidence interval, 2.2-3.1) than their 2676 matched controls (29% versus 14%). Classification tree analysis, based on independent risk factors, was used for the best prediction model of antidepressant use after sIA-SAH. Modified Rankin Scale until 12 months was the most potent predictor, followed by condition (Hunt and Hess Scale) and age on admission for sIA-SAH. Conclusions-The sIA-SAH survivors use significantly more often antidepressants, indicative of depression, than their matched population controls. Even with a seemingly good recovery (modified Rankin Scale score, 0) at 12 months after sIA-SAH, there is a significant risk of depression requiring antidepressant medication. (Stroke. 2016;47:2242-2248.

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Section: Strokementioning

confidence: 99%

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confidence: 99%

Antidepressant Use After Aneurysmal Subarachnoid Hemorrhage

Huttunen

Lindgren

Kurki

et al. 2016

Stroke

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“…KUH Neurosurgery and KUH Neurointensive Care have exclusively provided full-time (7 days, 24 h) acute and elective neurosurgical services for the KUH catchment population [8–10]. All cases of SAH diagnosed by CT or spinal tap are acutely transferred to KUH for neurointensive care, neuroradiology (4-vessel catheter angiography and/or CT angiography), and neurosurgical treatment.…”

Section: Methodsmentioning

confidence: 99%

“…The Kuopio Intracranial Aneurysm Patient and Family Database includes all aSAH patients admitted to the Kuopio University Hospital (KUH) from its defined Eastern Finnish catchment population [8]. In our previous study, the mortality of 1657 aSAH patients after acute hospitalization in1980–2007 was 11% at 3 days, 22% at 30 days, and 27% at 12 months [10]. In the present study, we analyzed 769 consecutive acute aSAH patients admitted to KUH Neurointensive Care from 2005 to 2015, including their data from the Finnish Transplantation Unit and the national clinical registries.…”

Section: Introductionmentioning

confidence: 99%

Identification of potential organ donors after aneurysmal subarachnoid hemorrhage in a population-based neurointensive care in Eastern Finland

et al. 2018

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BackgroundTo analyze the organ donation action in population-based neurointensive care of acute aneurysmal subarachnoid hemorrhage (aSAH) and to seek factors that would improve the identification of potential organ donors (PODs) and increase the donor conversion rate (DCR) after aSAH.MethodsThe Kuopio Intracranial Aneurysm Database, prospective since 1995, includes all aSAH patients admitted to the Kuopio University Hospital (KUH) from its defined Eastern Finnish catchment population. We analyzed 769 consecutive acute aSAH patients from 2005 to 2015, including their data from the Finnish Transplantation Unit and the national clinical registries. We analyzed PODs vs. actual donors among the 145 (19%) aSAH patients who died within 14 days of admission. Finland had implemented the national presumed consent (opt-out) within the study period in the end of 2010.ResultsWe retrospectively identified 83 (57%) PODs while only 49 (34%) had become actual donors (total DCR 59%); the causes for non-donorship were 15/34 (44%) refusals of consent, 18/34 (53%) medical contraindications for donation, and 1/34 (3%) failure of recognition. In 2005–2010, there were 11 refusals by near relatives with DCR 52% (29/56) and only three in 2011–2015 with DCR 74% (20/27). Severe condition on admission (Hunt and Hess grade IV or V) independently associated with the eventual POD status.ConclusionsNearly 20% of all aSAH patients acutely admitted to neurointensive care from a defined catchment population died within 14 days, almost half from cardiopulmonary causes at a median age of 69 years. Of all aSAH patients, 11% were considered as potential organ donors (PODs). Donor conversion rate (DCR) was increased from 52 to 74% after the national presumed consent (opt-out). Implicitly, DCR among aSAH patients could be increased by admitting them to the intensive care regardless of dismal prognosis for the survival, along a dedicated organ donation program for the catchment population.

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“…The clinical data of the 4,411 IA patients (620 familial and 3,780 sporadic patients) and their 46,021 relatives have been imported from the Finnish nationwide registries, including the hospital diagnoses, use of prescribed medicines, and causes of death [13][14][15][16][17]. The genealogy of the verified IA patients has been extensively mapped through parish records up to the 17th century.…”

Section: Methodsmentioning

confidence: 99%

Saccular Intracranial Aneurysms in Children When Both Parents Are Sporadic or Familial Carriers of Saccular Intracranial Aneurysms

et al. 2018

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Background and purpose: To study the penetrance of saccular intracranial aneurysm (IA) disease in children when both parents carry the disease. Patients and methods: The Kuopio IA Patient and Family Database includes all 4,411 IA patients admitted to the Kuopio University Hospital from its defined Eastern Finnish catchment population since 1980. We fused IA database with hospital diagnoses for IA patients and their 46,021 relatives from a national registry to identify couples concordant for IA disease. Penetrance of IA disease and hypertension were studied in these families. Results: A total of 3,659 IA patients had 1 or more children. In total, 18 couples concordant for the IA disease with a total of 48 children, all born healthy, were identified. Hypertension was diagnosed in 23 (64%) of the 36 parents, and 7 of the 12 sporadic-sporadic couples were concordant for hypertension. Six sporadic-sporadic couples were concordant for subarachnoid haemorrhage (SAH). None of the 24 children to the 12 sporadic-sporadic couples had been diagnosed with SAH or IA disease. Instead, 11 (46%) of the 24 children to the 6 familial-sporadic couples had a diagnosed with SAH or IA disease. Conclusions: Couples concordant for IA disease are uncommon but not exceedingly rare. Biparental sporadic exposure does not seem to increase the risk of a clinically diagnosed IA disease or SAH in the offspring. IAs were common in the children with biparental sporadic-familial exposure.

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Risk Factors for Three Phases of 12-Month Mortality in 1657 Patients from a Defined Population After Acute Aneurysmal Subarachnoid Hemorrhage

Cited by 59 publications

References 33 publications

Antidepressant Use After Aneurysmal Subarachnoid Hemorrhage

Antidepressant Use After Aneurysmal Subarachnoid Hemorrhage

Identification of potential organ donors after aneurysmal subarachnoid hemorrhage in a population-based neurointensive care in Eastern Finland

Saccular Intracranial Aneurysms in Children When Both Parents Are Sporadic or Familial Carriers of Saccular Intracranial Aneurysms

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