Abstract
Background
Cerebral vasospasm (cVSP) is a common complication in aneurysmal subarachnoid hemorrhage
(aSAH) and is associated with worse outcomes. However, clinical significance of asymptomatic
cVSP is poorly understood. We sought to determine the association of asymptomatic
cVSP with functional outcome and hospital length of stay (LOS).
Methods
We performed a retrospective study of a prospectively collected cohort of patients
with aSAH who survived hospitalization at an academic center between 2016 and 2021.
We defined cVSP based on transcranial Doppler criteria. Multivariate logistic and
multiple linear regression analyses were used to determine the association of asymptomatic
cVSP with poor functional outcome (defined as modified Rankin scale 3-6 at 3 months
after discharge) and hospital length of stay (LOS).
Results
The cohort consisted of 201 aSAH patients with a mean age 54.9 years (SD 13.6) and
60% were female. One hundred nine patients (54%) experienced cVSP, of whom 43 patients
(39%) were asymptomatic. Patients with asymptomatic cVSP were younger (mean 50.5 years
[SD 10.6] vs 61 years [SD12.5]; p < 0.001) and had longer ICU LOS (median 13 days [IQR12-20] vs median 12 days [IQR9-15],
p = 0.018) compared to those without cVSP. However, after adjusting with other variables
asymptomatic cVSP was not associated with longer ICU or hospital LOS. Asymptomatic
cVSP was not associated with poor outcome either (p = 0.14).
Conclusion
Asymptomatic cVSP, which was more common in younger patients, was neither associated
with poor functional outcome nor hospital LOS. Larger prospective studies are needed
to assess the significance of asymptomatic cVSP on long-term outcomes.
Keywords
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Article info
Publication history
Published online: October 12, 2022
Accepted:
October 3,
2022
Received in revised form:
September 20,
2022
Received:
August 17,
2022
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2022.106821
Copyright
© 2022 Elsevier Inc. All rights reserved.
