Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes

Lindgren, Cecilia M.; Söderberg, Stefan; Koskinen, Lars‐Owe D.; Hultin, Magnus; Edvardsson, L.; Naredi, Silvana

doi:10.1111/ane.12410

Cited by 11 publications

(5 citation statements)

References 35 publications

(57 reference statements)

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“…Diabetes could be a contributing factor to the long-term vascular mortality in some cases. Earlier publications have shown that SAH patients have an increased mortality due to cerebrovascular disorders [ 10 , 9 ]. The influence of previous stroke on mortality has not been addressed before, but this finding suggests that SAH may be part of a more systemic vascular disorder.…”

Section: Discussionmentioning

confidence: 99%

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The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

et al. 2023

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Purpose There is an an increasing awareness of the importance of health and lifestyle for stroke diseases like spontaneous subarachnoid hemorrhage (SAH). However, the importance of pre-existing medical conditions for clinical course and mortality after SAH has not been studied. The aim of the present study was to identify pre-existing conditions contributing to mortality after SAH. Methods Data were extracted from a Swedish national prospective study on patients with SAH. Variables were defined for age, sex, body mass index (BMI), clinical condition at admission, and for 10 pre-existing medical conditions. Models predicting mortality in three time intervals with all possible subsets of these variables were generated, compared and selected using Akaike’s information criterion. Results 1155 patients with ruptured aneurysms were included. The mortality within 1 week was 7.6%, 1 month 14.3%, and 1 year 18.7%. The most common pre-existing medical conditions were smoking (57.6%) and hypertension (38.7%). The model’s best predicting mortality within 1 week and from 1 week to 1 month included only the level of consciousness at admission and age, and these two variables were present in all the models among the top 200 in Akaike score for each time period. The most predictive model for mortality between 1 month and 1 year added previous stroke, diabetes, psychiatric disease, and BMI as predictors. Conclusion Mortality within the first month was best predicted simply by initial level of consciousness and age, while mortality within from 1 month to 1 year was significantly influenced by pre-existing medical conditions.

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Section: Discussionmentioning

confidence: 99%

“…There are studies on the cause of death after the acute phase, and in the short term, this correlated to cardiovascular incidents [ 11 ]. In the long term, mortality correlated with cerebrovascular disorders [ 10 ]. However, there are few or no studies on the impact of the earlier health and lifestyle on the mortality after SAH.…”

Section: Introductionmentioning

confidence: 99%

The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

et al. 2023

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“…It is estimated that more than 25% of patients with aSAH died in the hospital, and more than 40% have persistent neurological deficits 2 . Moreover, patients who survive the initial haemorrhage are susceptible to cerebrovascular diseases and have mortality rates that exceed the general population 3,4 . For example, the recurrence of aSAH in survivors was estimated to be 15‐times higher than that in the general population.…”

Section: Introductionmentioning

confidence: 99%

“…2 Moreover, patients who survive the initial haemorrhage are susceptible to cerebrovascular diseases and have mortality rates that exceed the general population. 3,4 For example, the recurrence of aSAH in survivors was estimated to be 15-times higher than that in the general population. Thus, it is critical to recognize the cellular and molecular differences between aneurysmal tissues from aSAH patients and normal intracranial arterial tissues, which could offer a theoretical basis for the high recurrence of cerebrovascular disease in patients with aSAH.Inflammatory reactions are involved in the formation, progression and deterioration of aSAH.…”

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confidence: 99%

Comprehensive analysis of immune cell infiltration and role of MSR1 expression in aneurysmal subarachnoid haemorrhage

et al. 2022

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Aneurysmal subarachnoid haemorrhage (aSAH), resulting from the rupture of intracranial aneurysms, can yield high mortality and disability. This study aimed to explore the immune infiltration of aneurysmal tissues and investigate a novel mechanism underlying aSAH. We downloaded datasets containing expression profiles of aneurysmal and normal arterial tissues from the online database. Then a comprehensive bioinformatic strategy was conducted to select the biomarkers of aneurysmal tissues.Two calculation algorithms were performed to identify the unique immune characteristics between aneurysmal tissues and normal arteries. Double immunofluorescence staining was used to investigate the role of pathway-related proteins in the inflammatory process after aSAH. Six microarray datasets were integrated, and another RNA-sequencing dataset was used as the validation dataset. Functional enrichment analysis of the differentially expressed genes indicated that immune-related processes were closely related to the progression of aSAH. We then performed immune microenvironment infiltration analysis, and the results suggested macrophages were abnormally enriched in aneurysmal tissues. Core gene MSR1 was filtered through a comprehensive bioinformatic strategy. Our analysis suggested that MSR1 might be associated with macrophage activation and migration. Our study elucidated the impact of macrophage and MSR1 on aSAH progression. These findings were helpful in gaining insight into the immune heterogeneity of aneurysmal tissues and normal arteries, and in identifying patients who might benefit from immunotherapy. | INTRODUCTIONAneurysmal subarachnoid haemorrhage (aSAH) is a deadly cerebrovascular disease. [1][2][3] It is estimated that more than 25% of patients with aSAH died in the hospital, and more than 40% have persistent neurological deficits. 2 Moreover, patients who survive the initial haemorrhage are susceptible to cerebrovascular diseases and have mortality rates that exceed the general population. 3,4 For example, the recurrence of aSAH in survivors was estimated to be 15-times higher than that in the general population. Thus, it is critical to recognize the cellular and molecular differences between aneurysmal tissues from aSAH patients and normal intracranial arterial tissues, which could offer a theoretical basis for the high recurrence of cerebrovascular disease in patients with aSAH.Inflammatory reactions are involved in the formation, progression and deterioration of aSAH. 5 Once the intracranial aneurysm (IA) ruptures, immune cells, haemoglobin and cytokines enter the central nervous system and mediate inflammatory responses. 6,7 Xing Wang and Dingke Wen contributed equally to this work as first authors.

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“…Aneurysmal subarachnoid hemorrhage (SAH) is a disease that affects the patient's prognosis with various complications even after clipping or coiling (1). aSAH activates a robust complement response exacerbating cell death and eventually leading to dysfunction of the blood-brain barrier (2, 3).…”

Section: Introductionmentioning

confidence: 99%

Serum mannose-binding lectin levels after aneurysmal subarachnoid hemorrhage

Cai

Sun

2016

Acta Neurol Scand

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Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes

Abstract: Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes Lindgren C, S€ oderberg S, Koskinen L-OD, Hultin M, Edvardsson L, Naredi S. Long-term subarachnoid haemorrhage survivors still die due to cerebrovascular causes. Acta Neurol Scand 2015: 132: 410-416.

Cited by 11 publications

References 35 publications

The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

The impact of previous health on the mortality after aneurysmal subarachnoid hemorrhage: analysis of a prospective Swedish multicenter study

Comprehensive analysis of immune cell infiltration and role of MSR1 expression in aneurysmal subarachnoid haemorrhage

Serum mannose-binding lectin levels after aneurysmal subarachnoid hemorrhage

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