Transient loss of consciousness in the manifestation of cerebral arterial aneurysm rupture as a predictor of the probability of fatal outcome. A univariate analysis

Abstract

Transient loss of consciousness (TLOC) is a common manifestation of aneurysmal subarachnoid hemorrhage (aSAH), observed in 26–53% of patients, and may serve as a prognostic indicator. However, limited research in Ukrainian literature addresses TLOC as a predictor of aSAH severity and outcomes. Objective. The study aimed to assess the impact of TLOC during the manifestation of ІCAA rupture on the time to fatal outcome in patients with WFNS grades I-III. Materials and methods. A retrospective analysis was conducted on the records of 60 deceased patients diagnosed with aSAH. Patients were divided into two groups based on the presence (n=22) or absence (n=38) of TLOC during the manifestation of the aSAH. Survival was analyzed using Kaplan-Meier curves and log-rank tests to determine independent predictors of mortality. Results. Median survival time was identical in both groups at 13 days, indicating similar overall dynamics of aSAH progression regardless of TLOC presence. However, the mean survival was shorter in Group 1 (14±3 days) compared to Group 2 (19±2 days), suggesting a trend toward reduced survival in patients with TLOC (p=0.186). Early survival (days 1–12) was similar across groups, with survival declining to 50% by day 12. After day 13, survival in Group 1 declined below 30% by day 15, while Group 2 maintained 30% survival until day 18. Latestage outcomes showed accelerated mortality in Group 1, with all patients deceased by day 62, compared to day 82 in Group 2. Conclusions. Patients who experienced TLOC tend to have shorter survival times, faster clinical deterioration, and a higher risk of fatal outcomes within the first 30 days after ICAA rupture, necessitating closer monitoring and more intensive therapy for these patients.

Тимчасова втрата свідомості (ТВС) є поширеним проявом субарахноїдального крововиливу з потенційним прогностичним значенням, проте в українській літературі бракує досліджень щодо її ролі як предиктора. У цьому дослідженні проаналізовано вплив ТВС під час розриву церебральної артеріальної аневризми на летальність пацієнтів з оцінкою тяжкості стану за шкалою WFNS I-III. Ретроспективний аналіз 60 історій хвороб померлих пацієнтів показав, що пацієнти з ТВС мають вищий ризик летального наслідку, швидше погіршення стану та скорочений час виживання. ТВС рекомендовано враховувати як предиктор прогнозу у пацієнтів з розривом церебральної артеріальної аневризми.