Significant increase in mortality and risk of acute ischemic stroke in infective endocarditis patients with subarachnoid hemorrhage secondary to mycotic aneurysms

被引:2
作者
Sursal, Tolga [1 ]
Clare, Kevin [2 ]
Feldstein, Eric [1 ]
Ogulnick, Jonathan [2 ]
Nolan, Bridget [2 ]
Karimov, Zafar [2 ]
Nazarenko, Andrew [2 ]
Ye, Linda [2 ]
Bornovski, Yarden [1 ]
Wong, Serena [1 ]
Goldberg, Joshua [3 ]
Mayer, Stephan A. [1 ]
Bauerschmidt, Andrew [1 ]
El Khoury, Marc Y. [4 ]
Al-Jehani, Hosam [5 ]
Gandhi, Chirag D. [1 ,2 ]
Al-Mufti, Fawaz [1 ,2 ,6 ]
机构
[1] Westchester Med Ctr, Brain & Spine Inst, Valhalla, NY 10595 USA
[2] New York Med Coll, Sch Med, Valhalla, NY 10595 USA
[3] New York Med Coll, Westchester Med Ctr, Sect Cardiothorac Surg, Valhalla, NY 10595 USA
[4] New York Med Coll, Westchester Med Ctr, Dept Med, Div Infect Dis,Sch Med, Valhalla, NY 10595 USA
[5] Imam Abdulrahman Bin Faisal Univ, Neurosurg, King Fahd Hosp Univ, Al Khobar, Saudi Arabia
[6] New York Med Coll, Westchester Med Ctr, Sch Med, 100 Woods Rd,Macy Pavil 1331, Valhalla, NY 10532 USA
关键词
Subarachnoid hemorrhage; Infective endocarditis; Acute ischemic stroke; National inpatient sample; ENDOVASCULAR TREATMENT; GENDER;
D O I
10.1016/j.jns.2023.120670
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Infective Endocarditis (IE) patients are known to have a variety of complications with one of the rarest, but serious being cerebral mycotic aneurysm, which can result in subarachnoid hemorrhage (SAH). Using the National In-Patient Sample database, we sought to determine the rate of acute ischemic stroke (AIS) and outcomes in IE- patients with and without SAH. In total, we identified 82,844 IE-patients from 2010 to 2016, of which 641 had a concurrent diagnosis of SAH. IE patients with SAH had a more complicated course, higher mortality rate (OR 4.65 CI 95% 3.9-5.5, P < 0.001), and worse outcomes. This patient population also had a significantly higher rate of AIS (OR 6.3 CI 95% 5.4-7.4, P < 0.001). Overall, 41.5% of IE-patients with SAH had AIS during their hospitalization as compared to 10.1% of IE only patients. IE-patients with SAH were more likely to undergo endovascular treatment (3.6%) with 0.8% of the IE patients with AIS undergoing mechanical thrombectomy. While IE-patients are at risk for various complications, our study suggests a significant increase in the mortality and risk of AIS in those with SAH.
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页数:5
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