Cardiac Outcome in Patients with Subarachnoid Hemorrhage and Electrocardiographic Abnormalities

Cardiac Outcome in Patients with Subarachnoid Hemorrhage and Electrocardiographic Abnormalities AbstractOBJECTIVEApproximately 25% of patients with subarachnoid hemorrhage (SAH) have electrocardiographic (ECG) abnormalities consistent with myocardial ischemia or myocardial infarction (MI), and their cardiac prognosis remains unclear. The objective of this study was to determine the cardiac and all-cause mortality rate of a series of patients with SAH with ECG changes consistent with ischemia or MI.METHODSUsing an existing database of patients with SAH and predetermined ECG criteria for ischemia or MI, a study group of patients with abnormal ECG results within 3 days of presentation and before aneurysm surgery was identified. Database patients without abnormal ECG results served as a control group. Cardiac mortality, defined as death resulting from arrhythmia, congestive heart failure, or cardiogenic shock, was assessed by chart review.RESULTSOf 439 patients with SAH in the database, 58 met the criteria for the study group. Forty-one of these patients were treated neurosurgically. No deaths resulting from cardiac causes occurred, and 20 patients died as a result of noncardiac causes. In a multivariable analysis, age older than 65 years and Hunt and Hess grade of at least 3 were predictive of all-cause mortality. ECG abnormalities, however, were not a statistically significant predictor.CONCLUSIONIn patients with SAH and ECG readings consistent with ischemia or Ml, the risk of death resulting from cardiac causes is low, with or without aneurysm surgery. The ECG abnormalities are associated with more severe neurological injury but are not independently predictive of all-cause mortality. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Cardiac Outcome in Patients with Subarachnoid Hemorrhage and Electrocardiographic Abnormalities

Cardiac Outcome in Patients with Subarachnoid Hemorrhage and Electrocardiographic Abnormalities

Cardiac Outcome in Patients with Subarachnoid Hemorrhage and Electrocardiographic Abnormalities Jonathan G. Zaroff, M .D ., Guy A. Rordorf, M .D ., John B. Newell, B.A., Christopher S. Ogilvy, M .D ., John R. Levinson, M .D ., Ph.D. Cardiac (JGZ, JBN, JRL), Neurology (G A R ), and Neurosurgery (C SO ) Units, Massachusetts General Hospital, Boston, Massachusetts O B JE C T IV E : Approximately 2 5 % of patients with subarachnoid hemorrhage (SAH) have electrocardiographic (ECG) abnormalities consistent with myocardial ischemia or myocardial infarction (Ml), and their cardiac prognosis remains unclear. The objective of this study was to determine the cardiac and all-cause mortality rate of a series of patients with SAH with E C G changes consistent with ischemia or Ml. M E T H O D S : Using an existing database of patients with SAH and predetermined E C G criteria for ischemia or Ml, a study group of patients with abnormal E C G results within 3 days of presentation and before aneurysm surgery was identified. Database patients without abnormal E C G results served as a control group. C ard iac mortality, defined as death resulting from arrhythmia, congestive heart failure, or cardiogenic shock, was assessed by chart review. RESULTS: O f 439 patients with SAH in the database, 58 met the criteria for the study group. Forty-one of these patients were treated neurosurgically. No deaths resulting from cardiac causes occurred, and 20 patients died as a result of noncardiac causes. In a multivariable analysis, age older than 65 years and Hunt and Hess grade of at least 3 were predictive of all-cause mortality. ECG abnormalities, however, were not a statistically significant predictor. C O N C L U S I O N : In patients with SAH and E C G readings consistent with ischemia or Ml, the risk of death resulting from cardiac causes is low, with or without aneurysm surgery. The E C G abnormalities are associated with more severe neurological injury but are not independently...
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Publisher
Congress of Neurological Surgeons
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199901000-00013
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVEApproximately 25% of patients with subarachnoid hemorrhage (SAH) have electrocardiographic (ECG) abnormalities consistent with myocardial ischemia or myocardial infarction (MI), and their cardiac prognosis remains unclear. The objective of this study was to determine the cardiac and all-cause mortality rate of a series of patients with SAH with ECG changes consistent with ischemia or MI.METHODSUsing an existing database of patients with SAH and predetermined ECG criteria for ischemia or MI, a study group of patients with abnormal ECG results within 3 days of presentation and before aneurysm surgery was identified. Database patients without abnormal ECG results served as a control group. Cardiac mortality, defined as death resulting from arrhythmia, congestive heart failure, or cardiogenic shock, was assessed by chart review.RESULTSOf 439 patients with SAH in the database, 58 met the criteria for the study group. Forty-one of these patients were treated neurosurgically. No deaths resulting from cardiac causes occurred, and 20 patients died as a result of noncardiac causes. In a multivariable analysis, age older than 65 years and Hunt and Hess grade of at least 3 were predictive of all-cause mortality. ECG abnormalities, however, were not a statistically significant predictor.CONCLUSIONIn patients with SAH and ECG readings consistent with ischemia or Ml, the risk of death resulting from cardiac causes is low, with or without aneurysm surgery. The ECG abnormalities are associated with more severe neurological injury but are not independently predictive of all-cause mortality.

Journal

NeurosurgeryOxford University Press

Published: Jan 1, 1999

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