Long-term vascular events after subarachnoid hemorrhage
Fernandez-Perez, Isabel (Universitat Autònoma de Barcelona)
Giralt Steinhauer, Eva (Institut Hospital del Mar d'Investigacions Mèdiques)
Cuadrado Godia, Elisa (Institut Hospital del Mar d'Investigacions Mèdiques)
Guimaraens, Leopoldo (Departament J Merland de Neuroangiografia Terapèutica (Barcelona, Catalunya))
Vivas, Elio (Departament J Merland de Neuroangiografia Terapèutica (Barcelona, Catalunya))
Saldaña, Jesus (Departament J Merland de Neuroangiografia Terapèutica (Barcelona, Catalunya))
Suárez-Pérez, Antoni (Hospital del Mar (Barcelona, Catalunya))
Macias-Gómez, Adrià (Hospital del Mar (Barcelona, Catalunya))
Revert-Barbera, Anna (Hospital del Mar (Barcelona, Catalunya))
Estragues-Gazquez, Isabel (Hospital del Mar (Barcelona, Catalunya))
Rodriguez Campello, Ana Maria (Institut Hospital del Mar d'Investigacions Mèdiques)
Jiménez-Balado, Joan (Institut Hospital del Mar d'Investigacions Mèdiques)
Rey-Álvarez, Lucia (Institut Hospital del Mar d'Investigacions Mèdiques)
Roquer González, Jaume (Institut Hospital del Mar d'Investigacions Mèdiques)
Jimenez-Conde, Jordi (Institut Hospital del Mar d'Investigacions Mèdiques)
Ois, Angel (Institut Hospital del Mar d'Investigacions Mèdiques)

Data:	2022
Resum:	Background: Spontaneous subarachnoid hemorrhage (SAH) long-term risk is not well known. Our aims are: describing long-term vascular event (VE) incidence rates in SAH survivors; describing VE: ischemic and/or hemorrhagic; identifying independent association of factors related to VE; and analyzing the usefulness of factors to increase predictive ability. Methods: A prospective cohort study of consecutive patients admitted to Hospital del Mar with a diagnosis of SAH (n = 566) between January 2007 and January 2020 was carried out. They were followed up until January 2021. The study endpoint was a new VE in the follow-up. We calculated both incidence rates and cumulative rates at 5 years. Cox regression survival models including vascular risk factors with and without specific data of SAH disease were developed. We analyzed ROC curves of all multivariate models. Results: The analyzed cohort included 423 non-fatal SAH cases. Total patient-years were 2468. 16 years. The average follow-up was 70. 03 ± 43. 14; range: 1-180 months. There were 49 VE detected in 47 patients, as 2 of them had more than 1 VE. Incidence rate was 0. 020 events_per_patient/year, cumulative incidence at 5 years was 11. 11%. The more frequent VE that we found were cerebrovascular (28/49), mainly ischemic (21/28). Disability after SAH and the presence of multiple aneurysms were independently associated with a VE risk and improved the predictive capacity of multivariate models (AUC 0. 679 vs 0. 764; p = 0. 0062). Conclusions: We reported a low vascular risk after SAH. We have shown the usefulness of SAH factors to identify patients with a higher risk of VE.
Ajuts:	Instituto de Salud Carlos III RD21/0006/0021 Instituto de Salud Carlos III PIO19/00011
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Subarachnoid Hemorrhage ; Vascular events ; Risk Factors
Publicat a:	Journal of neurology, Vol. 269, Núm. 11 (November 2022) , p. 6036-6042, ISSN 1432-1459

DOI: 10.1007/s00415-022-11255-z

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