VPS dependency after aneurysmal subarachnoid haemorrhage and influence of admission hyperglycaemia.


Journal

European stroke journal
ISSN: 2396-9881
Titre abrégé: Eur Stroke J
Pays: England
ID NLM: 101688446

Informations de publication

Date de publication:
03 2023
Historique:
received: 08 10 2022
accepted: 05 12 2022
medline: 7 4 2023
entrez: 6 4 2023
pubmed: 7 4 2023
Statut: ppublish

Résumé

Hydrocephalus after aneurysmal subarachnoid haemorrhage (aSAH) is a common complication which may lead to insertion of a ventriculoperitoneal shunt (VPS). Our aim is to evaluate a possible influence of specific clinical and biochemical factors on VPS dependency with special emphasis on hyperglycaemia on admission. Retrospective analysis of a monocentric database of aSAH patients. Using univariable and multivariable logistic regression analysis we evaluated factors influencing VPS dependency, with a special focus on hyperglycaemia on blood sample within 24 h of admission, dichotomised at 126 mg/dl. Factors evaluated in the univariable analysis were age, sex, known diabetes, Hunt and Hess grade, Barrow Neurological Institute scale, treatment modality, extra-ventricular drain (EVD) insertion, complications (rebleeding, vasospasm, infarction, decompressive craniectomy, ventriculitis), outcome variables and laboratory parameters (glucose, C-reactive protein, procalcitonin). We included 510 consecutive patients treated with acute aSAH requiring a VPS (mean age 58.2 years, 66% were female). An EVD was inserted in 387 (75.9%) patients. In the univariable analysis, VPS dependency was associated with hyperglycaemia on admission (OR 2.56, 95%CI 1.58-4.14, Hyperglycaemia on admission was associated with an increased probability of VPS placement. If confirmed, this finding might facilitate treatment of these patients by accelerating insertion of a permanent draining system.

Identifiants

pubmed: 37021154
doi: 10.1177/23969873221147087
pii: 10.1177_23969873221147087
pmc: PMC10069185
doi:

Types de publication

Journal Article

Langues

eng

Pagination

301-308

Informations de copyright

© European Stroke Organisation 2022.

Déclaration de conflit d'intérêts

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Auteurs

Isabel Charlotte Hostettler (IC)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.

Nicole Lange (N)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Nina Schwendinger (N)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Gareth Ambler (G)

Department of Statistical Science, University College London, London, UK.

Theresa Hirle (T)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Samira Frangoulis (S)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Dominik Trost (D)

Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Jens Gempt (J)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Kornelia Kreiser (K)

Department of Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Bernhard Meyer (B)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Christof Winter (C)

Institute of Clinical Chemistry and Pathobiochemistry, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

Maria Wostrack (M)

Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.

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