Author(s): Emmanuel E. Albano Jr, MD, DPBNS and Reynaldo Benedict V. Villamor Jr, MD, FAFN

Abstract:
Objective:
This study aims to determine the clinical outcome of patients diagnosed with aneurysmal subarachnoid hemorrhage and their association with grading scores.

Methods:
The authors conducted a single-center cross- sectional study involving patients diagnosed with aneurysmal subarachnoid hemorrhage admitted at Vicente Sotto Memorial Medical Center, Cebu City, Philippines from January 2015 to December 2020.

Results:
Out of 240 patients diagnosed with ruptured aneurysms, 215 underwent definitive treatment. The average age was 56 years old, predominantly female with a ratio of 2:1. Most patients were classified with admitting Hunt and Hess grading scale of 2-3 and Fisher grading scale of 3. Females had increased incidence of multiple aneurysms (ratio 3:1) compared to male sex. Among patients, 197 underwent clipping while 18 underwent coiling. Clinical Outcome revealed that 84% had good outcome while 16% had poor outcome. The association between Hunt and Hess grading scale and patient outcome was statistically significant (p<0.001) as well as for Fisher grading scale and patient outcome (p<0.001). Fisher grading scale and incidence of clinical vasospasm were also significant (p =0.004).

Conclusions:
Higher scores for Hunt and Hess grading scale and Fisher grading scale were associated with poor outcome. Higher Fisher grading scale was associated with the occurrence of clinical vasospasm among patients with ruptured aneurysm. Female sex also had higher aneurysm incidence with complex and more multiple aneurysms as compared to male sex.

Key words: aneurysm ruptured, subarachnoid hemorrhage, Hunt and Hess Grading Scale, Fisher Grading Scale

DOI: