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dc.contributor.authorNasr, Nathalieen
dc.contributor.authorGaio, Ritaen
dc.contributor.authorCzosnyka, Mareken
dc.contributor.authorBudohoski, Karolen
dc.contributor.authorLiu, Xiuyunen
dc.contributor.authorDonnelly, Josephen
dc.contributor.authorSykora, Mareken
dc.contributor.authorKirkpatrick, Peteren
dc.contributor.authorPavy-Le Traon, Anneen
dc.contributor.authorHaubrich, Christinaen
dc.contributor.authorLarrue, Vincenten
dc.contributor.authorSmielewski, Peteren
dc.date.accessioned2018-10-10T05:19:28Z
dc.date.available2018-10-10T05:19:28Z
dc.date.issued2018-07en
dc.identifier.issn0039-2499
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/283449
dc.description.abstractBACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage (SAH) is characterized by important changes in the autonomic nervous system with potentially adverse consequences. The baroreflex has a key role in regulating the autonomic nervous system. Its role in SAH outcome is not known. The purpose of this study was to evaluate the association between the baroreflex and the functional 3-month outcome in SAH. METHODS: The study used a prospective database of 101 patients hospitalized for SAH. We excluded patients receiving β-blockers or noradrenaline. Baroreflex sensitivity (BRS) was measured using the cross-correlation method. A good outcome was defined by a Glasgow Outcome Scale score at 4 or 5 at 3 months. RESULTS: Forty-eight patients were included. Median age was 58 years old (36-76 years); women/men: 34/14. The World Federation of Neurosurgery clinical severity score on admission was 1 or 2 for 73% of patients. In the univariate analysis, BRS (P=0.007), sedation (P=0.001), World Federation of Neurosurgery score (P=0.001), Glasgow score (P=0.002), Fisher score (P=0.022), and heart rate (P=0.037) were associated with outcome. The area under the receiver operating characteristic curve for the model with BRS as a single predictor was estimated at 0.835. For each unit increase in BRS, the odds for a good outcome were predicted to increase by 31%. Area under the receiver operating characteristic curve for heart rate alone was 0.670. In the multivariate analysis, BRS (odds ratio, 1.312; 95% confidence interval, 1.048-1.818; P=0.018) and World Federation of Neurosurgery (odds ratio, 0.382; 95% confidence interval, 0.171-0.706; P=0.001) were significantly associated with outcome. Area under the receiver operating characteristic curve was estimated at 0.900. CONCLUSIONS: In SAH, early BRS was associated with 3-month outcome. This conclusion requires confirmation on a larger number of patients in a multicentre study.
dc.languageengen
dc.publisherAmerican Heart Association,
dc.subjectautonomic nervous systemen
dc.subjectbaroreflexen
dc.subjectblood pressureen
dc.subjectstrokeen
dc.subjectsubarachnoid hemorrhageen
dc.titleBaroreflex Impairment After Subarachnoid Hemorrhage Is Associated With Unfavorable Outcome.en
dc.typeArticle
prism.endingPage1638
prism.issueIdentifier7en
prism.publicationDate2018en
prism.publicationNameStrokeen
prism.startingPage1632
prism.volume49en
dc.identifier.doi10.17863/CAM.30816
dcterms.dateAccepted2018-05-03en
rioxxterms.versionofrecord10.1161/STROKEAHA.118.020729en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-07en
dc.contributor.orcidCzosnyka, Marek [0000-0003-2446-8006]
dc.contributor.orcidDonnelly, Joseph [0000-0002-6502-8069]
dc.contributor.orcidSmielewski, Peter [0000-0001-5096-3938]
dc.identifier.eissn1524-4628
rioxxterms.typeJournal Article/Reviewen
dc.identifier.urlhttps://www.ahajournals.org/doi/10.1161/STROKEAHA.118.020729en
rioxxterms.freetoread.startdate2019-07-31


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