Sepsis and delayed cerebral ischemia are associated and have a cumulative effect on poor functional outcome in aneurysmal subarachnoid hemorrhage

• DOI: 10.3389/fneur.2024.1393989
• Publication Date: 2024-05-31T05:00:28Z
• Authors: Franz-Simon Centner; Holger Wenz; Mariella Eliana O...; Franz-Joseph Dally; Johannes Sauter-S...; Tanja Pelzer; Jochen J. Schoettler; Bianka Hahn; Amr Abdulazim; Katharian A. M. H...; Christoph Groden; Joerg Krebs; Manfred Thiel; Nima Etminan; Máté E. Maros
• Keywords: Brain ischemia

Objective Although sepsis and delayed cerebral ischemia (DCI) are severe complications in patients with aneurysmal subarachnoid hemorrhage (aSAH) share pathophysiological features, their interrelation additive effect on functional outcome is uncertain. We investigated the association between DCI cumulative aSAH using current sepsis-3 definition. Methods Patients admitted to our hospital 11/2014 11/2018 for were retrospectively analyzed. The main explanatory variable was sepsis, diagnosed criteria. Endpoints at discharge (modified Rankin Scale (mRS) 0–3 vs. 4–6). Propensity score matching (PSM) multivariable logistic regressions performed. Results Of 238 aSAH, 55 (23.1%) developed 74 (31.1%) DCI. After PSM, displayed significantly worse ( p < 0.01) longer ICU stay = 0.046). Sepsis independently associated (OR 2.46, 95%CI: 1.28–4.72, 0.01). However, after exclusion of who before 1.59, 0.78–3.24, 0.21) or 0.85, 0.37–1.95, 0.70) this statistical did not remain. Good gradually decreased from 56.3% (76/135) neither nor DCI, 43.8% (21/48) those no but 34.5% (10/29) 7.7% (2/26) both Conclusion Our study demonstrates a strong suggests complex interplay resulting towards poor outcome, which warrants further studies.