Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome
Background Electrocardiographic (ECG) alterations occurring after subarachnoid hemorrhage (SAH) have been described frequently, but the prognostic significance of these changes has not been well characterized. Aim and Objectives To report the prevalence and patterns of ECG alterations in...
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2013-01-01
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| Series: | Indian Journal of Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.110219 |
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| author | Saktheeswaran Mahesh Kumar Dinesh Choudhary Ajeet Arulkumar Thajudeen Anees Suresh Nair Jaganmohan A. Tharakan |
| author_facet | Saktheeswaran Mahesh Kumar Dinesh Choudhary Ajeet Arulkumar Thajudeen Anees Suresh Nair Jaganmohan A. Tharakan |
| author_sort | Saktheeswaran Mahesh Kumar |
| collection | DOAJ |
| description | Background
Electrocardiographic (ECG) alterations occurring after subarachnoid hemorrhage (SAH) have been described frequently, but the prognostic significance of these changes has not been well characterized.
Aim and Objectives
To report the prevalence and patterns of ECG alterations in patients with acute aneurysmal SAH and to study the relationship between ECG alterations and the neurological outcome, if any.
Materials and Methods
Records of consecutive patients admitted to the neurosurgical intensive care unit of the SCTIMST, Trivandrum between January 1999 and January 2011 with acute aneurysmal SAH were retrospectively analyzed.
Results
Of the 321 patients with SAH, 190 (59.2%) had abnormal ECGs. Repolarization abnormalities were the most common, with T wave inversion in the anterolateral leads occurring in 155 (48.3%) patients. By univariate analysis, female sex, Glasgow Coma Score (GCS) at admission of <15, World Federation of Neurological Surgeons (WFNS) grade >I, ST segment depression or T inversion in anterolateral leads, prolonged corrected QT interval, and sinus bradycardia were associated with increased risk of death. By multivariate analysis, only GCS and WFNS grade independently predicted mortality and none of the ECG changes predicted the same. Presence of tall T waves in anterior leads, T inversion in anterolateral leads, sinus bradycardia, and WFNS grade >1 were independently associated with GCS <15 and poor outcome at discharge.
Conclusions
In patients with acute aneurysmal SAH, repolarization abnormalities are the commonest ECG alterations. ECG alterations do not independently predict death, but independently predict poor discharge neurological status. |
| format | Article |
| id | doaj-art-0e4cdf39f5054022bb9446baa0ecf421 |
| institution | OA Journals |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-0e4cdf39f5054022bb9446baa0ecf4212025-08-20T01:59:13ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672013-01-01020105205610.4103/2277-9167.110219Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcomeSaktheeswaran Mahesh KumarDinesh ChoudharyAjeet ArulkumarThajudeen AneesSuresh Nair0Jaganmohan A. TharakanNeurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyBackground Electrocardiographic (ECG) alterations occurring after subarachnoid hemorrhage (SAH) have been described frequently, but the prognostic significance of these changes has not been well characterized. Aim and Objectives To report the prevalence and patterns of ECG alterations in patients with acute aneurysmal SAH and to study the relationship between ECG alterations and the neurological outcome, if any. Materials and Methods Records of consecutive patients admitted to the neurosurgical intensive care unit of the SCTIMST, Trivandrum between January 1999 and January 2011 with acute aneurysmal SAH were retrospectively analyzed. Results Of the 321 patients with SAH, 190 (59.2%) had abnormal ECGs. Repolarization abnormalities were the most common, with T wave inversion in the anterolateral leads occurring in 155 (48.3%) patients. By univariate analysis, female sex, Glasgow Coma Score (GCS) at admission of <15, World Federation of Neurological Surgeons (WFNS) grade >I, ST segment depression or T inversion in anterolateral leads, prolonged corrected QT interval, and sinus bradycardia were associated with increased risk of death. By multivariate analysis, only GCS and WFNS grade independently predicted mortality and none of the ECG changes predicted the same. Presence of tall T waves in anterior leads, T inversion in anterolateral leads, sinus bradycardia, and WFNS grade >1 were independently associated with GCS <15 and poor outcome at discharge. Conclusions In patients with acute aneurysmal SAH, repolarization abnormalities are the commonest ECG alterations. ECG alterations do not independently predict death, but independently predict poor discharge neurological status.http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.110219electrocardiographic changesneurological outcomesubarachnoid hemorrhage |
| spellingShingle | Saktheeswaran Mahesh Kumar Dinesh Choudhary Ajeet Arulkumar Thajudeen Anees Suresh Nair Jaganmohan A. Tharakan Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome Indian Journal of Neurosurgery electrocardiographic changes neurological outcome subarachnoid hemorrhage |
| title | Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| title_full | Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| title_fullStr | Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| title_full_unstemmed | Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| title_short | Prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| title_sort | prevalence of electrocardiographic changes in patients with acute aneurysmal subarachnoid hemorrhage and their relationship with outcome |
| topic | electrocardiographic changes neurological outcome subarachnoid hemorrhage |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.110219 |
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