Return to Driving Is a Better Predictor of Patient Outcome Than Return to Work After Aneurysmal Subarachnoid Hemorrhage

Objectives: The characteristics of serum catecholamine concentration at the hyper-acute phase of aneurysmal subarachnoid hemorrhage (SAH) and its relationship between patient outcome and delayed vasospasm were investigated. Methods: Patients with aneurysmal SAH (170) were prospectively studied between August 2008 and June 2011. Baseline demographic data and physiological parameters, including plasma concentrations of adrenaline (AD), noradrenaline (NA) and dopamine (DP) were evaluated for all patients. Results: On admission, plasma AD, NA and DP levels were significantly higher in patients with a poor clinical grade on admission (Hunt & Kosnik: IV-V), compared to those with a good clinical grade on admission (Hunt & Kosnik: I-III). AD showed a markedly high concentration immediately after the onset of SAH and then rapidly decreased. NA levels peaked within 6 hours after onset, then significantly decreased. The increase of DP with time was not significant, but showed a similar trend to that of NA. The level of each catecholamine showed significant mutual correlation. Multivariate analyses demonstrated age, poor clinical grade, plasma AD and NA levels were predictors of poor patient outcome, and.poor clinical grade, Fisher scale and plasma AD level were predictors of the development of delayed vasospasm. Conclusions: The present findings suggest that sympathetic activation in patients in the acute phase of SAH reflects the severity of SAH, and is closely related to the development of delayed vasospasm, leading to the subsequent immune response and inflammatory reactions. Strategies for suppressing catecholamine at the hyperacute phase may contribute to vasospasm prevention and improve patient outcome.

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Factors Influencing Return to Work After Aneurysmal Subarachnoid Hemorrhage

Journal of Neuroscience Nursing ◽

10.1097/jnn.0000000000000067 ◽

2014 ◽

Vol 46 (4) ◽

pp. 207-217 ◽

Cited By ~ 10

Author(s):

Catherine Harris

Keyword(s):

Subarachnoid Hemorrhage ◽

Return To Work ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Factors Influencing

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Resumption of work after aneurysmal subarachnoid hemorrhage in middle-aged Japanese patients

Journal of Neurosurgery ◽

10.3171/jns.1999.90.1.0059 ◽

1999 ◽

Vol 90 (1) ◽

pp. 59-64 ◽

Cited By ~ 24

Author(s):

Akiko Nishino ◽

Yoshiharu Sakurai ◽

Ichiro Tsuji ◽

Hiroaki Arai ◽

Hiroshi Uenohara ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Return To Work ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Japanese Patients ◽

Socioeconomic Background ◽

Content Type ◽

Employment System ◽

Results Of Treatment ◽

Work Resumption ◽

Fine Print

Object. Previous reports on the results of treatment for aneurysmal subarachnoid hemorrhage (SAH) have been based only on activities of daily living after discharge, whereas resumption of work has received insufficient attention. Most Japanese work under a lifetime employment system, and it is best for those who have recovered from SAH to return to work for their previous employer. The present study was conducted to determine the extent to which discharged patients who have suffered an SAH resume their former occupations in Japan, focusing on those between 40 and 49 years of age, who usually have a strong desire to return to work.Methods. The participants consisted of 193 patients with SAH. Based on the results of telephone interviews or written questionnaires, their work status at 1 year after onset was analyzed.The work resumption rates for patients with Hunt and Kosnik neurological Grades 1 or 2 on admission were higher than for those with Grades 3 or 4 (p = 0.015) and lower for patients with basilar artery aneurysms than for those with aneurysms at other sites (p = 0.028). With regard to premorbid occupation, the work resumption rates were high (80%) for professionals and engineers, many of whom were public servants, or teachers at junior or senior high schools. The resumption rates were also high for primary industry workers (80%), but lowest (20%) for professional drivers (p = 0.04–0.001). The work resumption rate was lower for women than for men (p = 0.01).Conclusions. These findings indicate that resumption of work is determined not only by medical factors, but also by social factors including gender, type of occupation, employment system, and socioeconomic background.

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Dynamic Pattern of Interleukin-1beta and -10 in Cerebrospinal Fluid following Aneurysmal Subarachnoid Hemorrhage

The Indonesian Biomedical Journal ◽

10.18585/inabj.v6i2.35 ◽

2014 ◽

Vol 6 (2) ◽

pp. 97

Author(s):

Yesaya Yunus ◽

Julius July ◽

Andi Asadul Islam ◽

Eka Julianta Wahjoepramono ◽

Irawan Yusuf

Keyword(s):

Patient Outcome ◽

Cerebrospinal Fluid ◽

Subarachnoid Hemorrhage ◽

Inflammatory Cytokine ◽

Prospective Observational Study ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Neurological Deficits ◽

Enzyme Linked Immunosorbent Assay ◽

Wilcoxon Rank Sum Test ◽

Anti Inflammatory Cytokine

BACKGROUND: Inflammation following aneurysmal subarachnoid hemorrhage (SAH) is associated with patient outcome. This study aimed to analyze the dynamics pattern of the pro-inflammatory interleukin (IL)-1β and anti-inflammatory cytokine IL-10 in the cerebrospinal fluid (CSF) following aneurysmal SAH.METHODS: This is a prospective observational study. The CSF was collected prior to surgery, and on the 2nd, 4th and 6th days after surgery. The CSF was then analyzed for IL-1β and -10 using enzyme-linked immunosorbent assay. Delayed Ischemic Neurological Deficits (DIND) was determined based on new neurological deficits within the first week after surgery. Data was analysed with T test or Wilcoxon Rank-Sum test to evaluate the pattern of biomarkers between DIND and non-DIND groups.RESULTS: There were 33 patients enrolled in this study, 16 patients (48.48%) who experienced DIND and 17 patients (51.52%) were non-DIND. There were significant increase dynamic levels of IL-10 and -1β in DIND patients (p<0.05).CONCLUSION: Significant increase levels of IL-10 and -1β in CSF after aneurysmal SAH are associated with DIND.KEYWORDS: IL-1β, IL-10, DIND

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