Development of cerebral vasospasm following traumatic intracranial hemorrhage: incidence, risk factors, and clinical outcomes

作者：Alis J. Dicpinigaitis, Eric Feldstein, Nitesh Damodara, Jared Cooper, Steven D. Shapiro, Haris Kamal, Merritt Drew Kinon, Jared M. Pisapia, Jon B. Rosenberg, Chirag D. Gandhi, Fawaz Al‐Mufti · 发表于：Neurosurgical FOCUS · 年份：2022 · DOI：10.3171/2021.12.focus21668 · 被引用次数：18 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Intracranial Aneurysms: Treatment and Complications、Traumatic Brain Injury and Neurovascular Disturbances

OBJECTIVE: Limited evidence exists characterizing the incidence, risk factors, and clinical associations of cerebral vasospasm following traumatic intracranial hemorrhage (tICH) on a large scale. Therefore, the authors sought to use data from a national inpatient registry to investigate these aspects of posttraumatic vasospasm (PTV) to further elucidate potential causes of neurological morbidity and mortality subsequent to the initial insult. METHODS: Weighted discharge data from the National (Nationwide) Inpatient Sample from 2015 to 2018 were queried to identify patients with tICH who underwent diagnostic angiography in the same admission and, subsequently, those who developed angiographically confirmed cerebral vasospasm. Multivariable logistic regression analysis was performed to identify significant associations between clinical covariates and the development of vasospasm, and a tICH vasospasm predictive model (tICH-VPM) was generated based on the effect sizes of these parameters. RESULTS: Among 5880 identified patients with tICH, 375 developed PTV corresponding to an incidence of 6.4%. Multivariable adjusted modeling determined that the following clinical covariates were independently associated with the development of PTV, among others: age (adjusted odds ratio [aOR] 0.98, 95% CI 0.97-0.99; p < 0.001), admission Glasgow Coma Scale score < 9 (aOR 1.80, 95% CI 1.12-2.90; p = 0.015), intraventricular hemorrhage (aOR 6.27, 95% CI 3.49-11.26; p < 0.001), tobacco smoking (aO...