Effect of preexisting cardiac disease on cardiac complications, vasospasm and neurologic deterioration following subarachnoid hemorrhage

2.50
Hdl Handle:
http://hdl.handle.net/10755/163603
Category:
Abstract
Type:
Presentation
Title:
Effect of preexisting cardiac disease on cardiac complications, vasospasm and neurologic deterioration following subarachnoid hemorrhage
Author(s):
Crago, Elizabeth A.; Kerr, Mary E.; Fails, Michelle
Author Details:
Elizabeth Crago, RN, MSN, Research Associate, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ecrago@pitt.edu; Mary E. Kerr; Michelle Fails
Abstract:
Purpose: The purpose of this study was to examine the relationship between a history of cardiac disease (HxCD) and the development of cardiac complications (CdCs), cerebral vasospasm and neurological deterioration (ND) following subarachnoid hemorrhage (SAH). Hypothesis: HxCD is related to CdC, angiographic vasospasm, and ND in patients with SAH. Framework: CdCs have been reported in SAH. There is an assumption that HxCD increases one's risk for CdCs and contributes to cerebral vasospasm and neurological deterioration (ND). Method: This prospective study included 81 SAH patients with a Fisher grade of > 2 and or a Hunt and Hess grade of > 3 admitted to the NeuroVascular ICU (NICU). Clinical records were reviewed for HxCD (defined as a history of hypertension, coronary artery disease, coronary artery bypass surgery, arrhythmias, or a permanent pacemaker). CdCs in the NICU were defined as elevation in cardiac enzymes or troponin, abnormal EKG or echocardiogram suggestive of a myocardial infarction, arrhythmias, or pulmonary edema. ND was assessed every 2 hours and defined as a decline of > 2 Glasgow Coma Score, or a deterioration in pupillary, motor or sensory response. Cerebral angiograms verified cerebral vasospasm (none/mild, moderate, severe). Descriptive and chi square analyses (alpha =.05) were conducted. Results: There was no significant relationship between a HxCD and vasospasm or CdC. Of the 81 patients, 37% (n=30) developed vasospasm-related ND [18 patients without HxCD (36.7%) versus 12 patients with HxCD (37.5%)]. An additional 6 patients (7.4%) developed cardiac-related ND [4 patients without HxCD (8.2%) versus 2 patients with HxCD (6.3%)]. Of the 32 patients (40%) with a positive HxCD, 11 (34%) experienced a CdC. Of the 49 patients (60%) without HxCD, 12 (25%) experienced a CdC. All CdC occurred within 5 days of the initial SAH. Conclusions: HxCD is not a predictive factor in CdC or vasospasm after SAH. Fifty percent of patients in this study with CdC did not have a positive HxCD. Implications for nursing practice and knowledge development: The incidence of CdCs and SAH suggests a need to routinely monitor all SAH patients regardless of HxCD for CdC in the first days after SAH. It also places an emphasis on the ability of the bedside nurse to manage all aspects of patient care regardless of patient diagnosis or ICU specialty.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEffect of preexisting cardiac disease on cardiac complications, vasospasm and neurologic deterioration following subarachnoid hemorrhageen_GB
dc.contributor.authorCrago, Elizabeth A.en_US
dc.contributor.authorKerr, Mary E.en_US
dc.contributor.authorFails, Michelleen_US
dc.author.detailsElizabeth Crago, RN, MSN, Research Associate, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA, email: ecrago@pitt.edu; Mary E. Kerr; Michelle Failsen_US
dc.identifier.urihttp://hdl.handle.net/10755/163603-
dc.description.abstractPurpose: The purpose of this study was to examine the relationship between a history of cardiac disease (HxCD) and the development of cardiac complications (CdCs), cerebral vasospasm and neurological deterioration (ND) following subarachnoid hemorrhage (SAH). Hypothesis: HxCD is related to CdC, angiographic vasospasm, and ND in patients with SAH. Framework: CdCs have been reported in SAH. There is an assumption that HxCD increases one's risk for CdCs and contributes to cerebral vasospasm and neurological deterioration (ND). Method: This prospective study included 81 SAH patients with a Fisher grade of > 2 and or a Hunt and Hess grade of > 3 admitted to the NeuroVascular ICU (NICU). Clinical records were reviewed for HxCD (defined as a history of hypertension, coronary artery disease, coronary artery bypass surgery, arrhythmias, or a permanent pacemaker). CdCs in the NICU were defined as elevation in cardiac enzymes or troponin, abnormal EKG or echocardiogram suggestive of a myocardial infarction, arrhythmias, or pulmonary edema. ND was assessed every 2 hours and defined as a decline of > 2 Glasgow Coma Score, or a deterioration in pupillary, motor or sensory response. Cerebral angiograms verified cerebral vasospasm (none/mild, moderate, severe). Descriptive and chi square analyses (alpha =.05) were conducted. Results: There was no significant relationship between a HxCD and vasospasm or CdC. Of the 81 patients, 37% (n=30) developed vasospasm-related ND [18 patients without HxCD (36.7%) versus 12 patients with HxCD (37.5%)]. An additional 6 patients (7.4%) developed cardiac-related ND [4 patients without HxCD (8.2%) versus 2 patients with HxCD (6.3%)]. Of the 32 patients (40%) with a positive HxCD, 11 (34%) experienced a CdC. Of the 49 patients (60%) without HxCD, 12 (25%) experienced a CdC. All CdC occurred within 5 days of the initial SAH. Conclusions: HxCD is not a predictive factor in CdC or vasospasm after SAH. Fifty percent of patients in this study with CdC did not have a positive HxCD. Implications for nursing practice and knowledge development: The incidence of CdCs and SAH suggests a need to routinely monitor all SAH patients regardless of HxCD for CdC in the first days after SAH. It also places an emphasis on the ability of the bedside nurse to manage all aspects of patient care regardless of patient diagnosis or ICU specialty.en_GB
dc.date.available2011-10-27T11:10:28Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:10:28Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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