Factors related to intracerebral haematoma in patients with aneurysmal subarachnoid haemorrhage in Vietnam: a multicentre prospective cohort study
Tuan Anh Nguyen,
Son Ngoc Do,
Co Xuan Dao,
My Ha Nguyen,
Dung Thi Pham,
Hai Bui Hoang,
Chi Van Nguyen,
Anh Dat Nguyen,
Chinh Quoc Luong,
Ton Duy Mai,
Luu Dang Vu,
Hung Manh Ngo,
Tuan Anh Tran,
Trang Quynh Pham,
Linh Quoc Nguyen,
Phuong Viet Dao,
Duong Ngoc Nguyen,
Hien Thi Thu Vuong,
Hung Dinh Vu,
Dong Duc Nguyen,
Thanh Dang Vu,
Dung Tien Nguyen,
Anh Le Ngoc Do,
Quynh Thi Pham,
Nhung Hong Khuat,
Ninh Van Duong,
Cong Chi Ngo,
Hao The Nguyen
Affiliations
Tuan Anh Nguyen
4 Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
Son Ngoc Do
1 Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam
Co Xuan Dao
1 Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam
My Ha Nguyen
Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
Dung Thi Pham
6 Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh City, Thai Binh, Viet Nam
Hai Bui Hoang
2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Chi Van Nguyen
Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
Anh Dat Nguyen
2 Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Chinh Quoc Luong
Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
Ton Duy Mai
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Luu Dang Vu
Department of Radiology, Hanoi Medical University, Hanoi, Viet Nam
Hung Manh Ngo
Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
Tuan Anh Tran
Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
Trang Quynh Pham
Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
Linh Quoc Nguyen
Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
Phuong Viet Dao
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Duong Ngoc Nguyen
Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
Hien Thi Thu Vuong
Department of Emergency, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, Viet Nam
Hung Dinh Vu
Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam
Dong Duc Nguyen
Department of Neurosurgery II, Neurosurgery Center, Vietnam-Germany Friendship Hospital, Hanoi, Viet Nam
Thanh Dang Vu
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Dung Tien Nguyen
Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam
Anh Le Ngoc Do
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Quynh Thi Pham
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Nhung Hong Khuat
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Ninh Van Duong
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Cong Chi Ngo
Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
Hao The Nguyen
Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
Objectives To investigate the impact of intracerebral haematoma (ICH) on the outcomes and the factors related to an ICH in patients with aneurysmal subarachnoid haemorrhage (aSAH) in a low- and middle-income country.Design A multicentre prospective cohort study.Setting Three central hospitals in Hanoi, Vietnam.Participants This study included all patients (≥18 years) presenting with aSAH to the three central hospitals within 4 days of ictus, from August 2019 to June 2021, and excluded patients for whom the admission Glasgow Coma Scale was unable to be scored or patients who became lost at 90 days of follow-up during the study.Outcome measures The primary outcome was ICH after aneurysm rupture, defined as ICH detected on an admission head CT scan. The secondary outcomes were 90-day poor outcomes and 90-day death.Results Of 415 patients, 217 (52.3%) were females, and the median age was 57.0 years (IQR: 48.0–67.0). ICH was present in 20.5% (85/415) of patients with aSAH. There was a significant difference in the 90-day poor outcomes (43.5% (37/85) and 29.1% (96/330); p=0.011) and 90-day mortality (36.5% (31/85) and 20.0% (66/330); p=0.001) between patients who had ICH and patients who did not have ICH. The multivariable regression analysis showed that systolic blood pressure (SBP) ≥140 mm Hg (adjusted odds ratio (AOR): 2.674; 95% CI: 1.372 to 5.214; p=0.004), World Federation of Neurosurgical Societies (WFNS) grades II (AOR: 3.683; 95% CI: 1.250 to 10.858; p=0.018) to V (AOR: 6.912; 95% CI: 2.553 to 18.709; p<0.001) and a ruptured middle cerebral artery (MCA) aneurysm (AOR: 3.717; 95% CI: 1.848 to 7.477; p<0.001) were independently associated with ICH on admission.Conclusions In this study, ICH was present in a substantial proportion of patients with aSAH and contributed significantly to a high rate of poor outcomes and death. Higher SBP, worse WFNS grades and ruptured MCA aneurysms were independently associated with ICH on admission.
