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Warning headache correlates survival rate in aneurysmal subarachnoid hemorrhage
- Source :
- Biomedical Journal, Biomedical Journal, Vol 42, Iss 5, Pp 352-357 (2019)
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- Background: Severe headaches, projectile vomiting, focal neurological deficits and early onset seizure are regarded as early warning symptoms of subarachnoid hemorrhage (SAH). Earlier diagnosis based on such warning symptoms theoretically would improve the clinical prognosis. However, it is still not clear whether the prognosis is correlated with early warning symptoms. Here, we reviewed warning symptoms and other predictive factors in the emergency room (ER) setting and examined their correlations with mortality. Methods: Ninety saccular aneurysmal SAH cases were reviewed in a single medical center between January 2011 and December 2013. We examined differences in mortality rate related to warning symptoms, SAH scales, onset-to-ER time, hydrocephalus, and aneurysm size, location, and complexity. Logistic regression analyses were performed to determine the correlations of warning symptoms and other predictive factors with mortality. Receiver operating characteristic (ROC) curve analysis was used to calculate the area the under curve (AUC) of SAH mortality prediction tools. Results: Warning headache, projectile vomiting, the Hunt and Hess scale, Fisher scale, World Federation of Neurological Surgeons (WFNS) grading scale, and modified WFNS (m-WFNS) scale, body mass index, aneurysm complexity and hydrocephalus were significantly different between the survivors and the decedents. The warning headache and WFNS grade were strongly correlated with mortality. The rate of prognostic prediction improved from 90.4% to 94.6% when warning headache was additionally evaluated. Conclusions: With growing healthcare costs and recognition of the value of palliative care, early identification via warning headache and a detailed clinical history review is necessary for cases of aSAH. Keywords: Warning headache, SAH, WFNS, Survival rate
- Subjects :
- Adult
Male
0301 basic medicine
Original article
Survival rate
Pediatrics
medicine.medical_specialty
Palliative care
Subarachnoid hemorrhage
Risk Assessment
03 medical and health sciences
0302 clinical medicine
medicine
Humans
cardiovascular diseases
lcsh:QH301-705.5
Aged
Retrospective Studies
lcsh:R5-920
Warning system
Receiver operating characteristic
business.industry
Mortality rate
Headache
WFNS
General Medicine
Middle Aged
Subarachnoid Hemorrhage
Prognosis
medicine.disease
Hydrocephalus
Warning headache
030104 developmental biology
lcsh:Biology (General)
ROC Curve
Area Under Curve
SAH
030220 oncology & carcinogenesis
Female
Headaches
medicine.symptom
lcsh:Medicine (General)
business
Subjects
Details
- ISSN :
- 23194170
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Biomedical Journal
- Accession number :
- edsair.doi.dedup.....4ffc301874617a86a727c82c6775fcfd
- Full Text :
- https://doi.org/10.1016/j.bj.2019.04.006