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Abstract：
Background and Objectives: Aneurysmal subarachnoid hemorrhage (ASAH) is defined as bleeding in the subarachnoid space caused by the rupture of a cerebral aneurysm. About 11% of people who develop ASAH die before receiving medical treatment, and 40% of patients die within four weeks of being admitted to hospital. There are limited data on single-center experiences analyzing intrahospital mortality in ASAH patients treated with an endovascular approach. Given that, we wanted to share our experience and explore the risk factors that influence intrahospital mortality in patients with ruptured intracranial aneurysms treated with endovascular coil embolization. Materials and Methods: Our study was designed as a clinical, observational, retrospective cross-sectional study. It was performed at the Department for Radiology, University Clinical Center Kragujevac in Kragujevac, Serbia. The study inclusion criteria were ≥18 years, admitted within 24 h of symptoms onset, acute SAH diagnosed on CT, aneurysm on DSA, and treated by endovascular coil embolization from January 2014 to December 2018 at our institution. Results: A total of 66 patients were included in the study-48 (72.7%) women and 18 (27.3%) men, and 19.7% of the patients died during hospitalization. After adjustment, the following factors were associated with in-hospital mortality: a delayed ischemic neurological deficit, the presence of blood in the fourth cerebral ventricle, and an elevated urea value after endovascular intervention, increasing the chances of mortality by 16.3, 12, and 12.6 times. Conclusions: Delayed cerebral ischemia and intraventricular hemorrhage on initial head CT scan are strong predictors of intrahospital mortality in ASAH patients. Also, it is important to monitor kidney function and urea levels in ASAH patients, considering that elevated urea values after endovascular aneurysm embolization have been shown to be a significant risk factor for intrahospital mortality.
摘要：
背景和目的：动脉瘤性蛛网膜下腔出血（ASAH）定义为由脑动脉瘤破裂引起的蛛网膜下腔出血。大约11％的发展ASAH的人在接受治疗之前死亡，40%的患者在入院后4周内死亡。单中心分析ASAH血管内治疗患者院内死亡率的经验数据有限。鉴于此,我们希望分享我们的经验,并探讨影响血管内弹簧圈栓塞治疗颅内动脉瘤破裂患者院内死亡率的危险因素.材料和方法：我们的研究设计为临床，观察,回顾性横断面研究。它是在放射科进行的，克拉古耶瓦茨大学临床中心，塞尔维亚。研究纳入标准≥18岁，在症状发作后24小时内入院，CT诊断为急性SAH,DSA上的动脉瘤，2014年1月至2018年12月在我院接受血管内弹簧圈栓塞治疗。结果：共有66例患者被纳入研究-48例（72.7%）女性和18例（27.3%）男性，19.7%的患者在住院期间死亡。调整后,以下因素与住院死亡率相关：迟发性缺血性神经功能缺损，第四脑室有血液，血管内介入后尿素值升高，死亡率分别增加16.3、12和12.6倍。结论：初次头颅CT扫描时迟发性脑缺血和脑室内出血是ASAH患者院内死亡率的强预测因子。此外，监测ASAH患者的肾功能和尿素水平非常重要，考虑到血管内动脉瘤栓塞后尿素值升高已被证明是院内死亡率的重要危险因素.
