Standardizing criteria for measuring vasospasm, neurologic deterioration and ischemia following subarachnois hemorrhage

2.50
Hdl Handle:
http://hdl.handle.net/10755/163648
Category:
Abstract
Type:
Presentation
Title:
Standardizing criteria for measuring vasospasm, neurologic deterioration and ischemia following subarachnois hemorrhage
Author(s):
Kerr, Mary; Cargo, Elizabeth A.; Yonas, Howard
Author Details:
Mary Kerr, University of Pittsburgh, Pittsburgh , Pennsylvania, USA, email: mek1@pitt.edu; Elizabeth A. Cargo; Howard Yonas
Abstract:
Introduction: Comparing the results of multiple studies involving subarachnoid hemorrhage (SAH) is difficult due to the variety of terminology and criteria used to define complications such as neurologic deterioration (ND) and cerebral vasospasm. Purpose: Identify the terminology, definitions and criteria used in clinical studies involving the three complications (ND, cerebral vasospasm and ischemia) following a SAH. Research Question: What are the similarities and differences in the conceptual definitions and criteria of ND, cerebral vasospasm and ischemia? Framework: Cerebral vasospasm after SAH increases the risk of cerebral ischemia clinically detected by the development of symptoms of neurologic deterioration. Methods: Published clinical studies from 1975 to the present involving patients within 14 days after a SAH were identified from Medline and the National Library of Medicine. Inclusion criteria were that the article was a) in English, b) available for review and c) involved > 5 patients with ruptured aneurysm. Excluded were case studies, review articles, letters or editorials. Hard copies of 480 articles were reviewed; 269 articles are included in this analysis. Terminology, definitions and criteria for each complication were extracted and entered in an Excel spreadsheet and analyzed using descriptive statistics. Results and Conclusions. Vasospasm was described using 23 different "labels" in 219 studies (81%). Symptomatic vasospasm (n=63; 28.7%) and cerebral vasospasm (n=16; 7.3%) were most frequently used to describe vasospasm (with and without ND). Vasospasm was detected using angiography (n=141; 64%), transcranial Doppler (TCD) (n=84; 38.3%) or both TCD and angiography (n=38; 17.3%). In studies involving ND (n=54), the most frequent labels were neurologic worsening (n=33; 21.4%), delayed cerebral ischemia (DCI) (n=25; 16.2%), delayed ischaemic deficit (DID) (n=25; 16.2%) and neurologic deficits (n=21; 13.6%). Criteria was not provided in most studies to differentiate ND with ischemia (DCI or DID) from ND without ischemia. Ischemia and infarction, used synonymously, were primarily measured as hypodensity on the CT. Implications for knowledge development: Inconsistent terminology and criteria for vasospasm, ND and ischemia persist over the past 25 years in studies involving a SAH. This lack of standardization places in question the results of research involving complications after a SAH.
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.titleStandardizing criteria for measuring vasospasm, neurologic deterioration and ischemia following subarachnois hemorrhageen_GB
dc.contributor.authorKerr, Maryen_US
dc.contributor.authorCargo, Elizabeth A.en_US
dc.contributor.authorYonas, Howarden_US
dc.author.detailsMary Kerr, University of Pittsburgh, Pittsburgh , Pennsylvania, USA, email: mek1@pitt.edu; Elizabeth A. Cargo; Howard Yonasen_US
dc.identifier.urihttp://hdl.handle.net/10755/163648-
dc.description.abstractIntroduction: Comparing the results of multiple studies involving subarachnoid hemorrhage (SAH) is difficult due to the variety of terminology and criteria used to define complications such as neurologic deterioration (ND) and cerebral vasospasm. Purpose: Identify the terminology, definitions and criteria used in clinical studies involving the three complications (ND, cerebral vasospasm and ischemia) following a SAH. Research Question: What are the similarities and differences in the conceptual definitions and criteria of ND, cerebral vasospasm and ischemia? Framework: Cerebral vasospasm after SAH increases the risk of cerebral ischemia clinically detected by the development of symptoms of neurologic deterioration. Methods: Published clinical studies from 1975 to the present involving patients within 14 days after a SAH were identified from Medline and the National Library of Medicine. Inclusion criteria were that the article was a) in English, b) available for review and c) involved > 5 patients with ruptured aneurysm. Excluded were case studies, review articles, letters or editorials. Hard copies of 480 articles were reviewed; 269 articles are included in this analysis. Terminology, definitions and criteria for each complication were extracted and entered in an Excel spreadsheet and analyzed using descriptive statistics. Results and Conclusions. Vasospasm was described using 23 different "labels" in 219 studies (81%). Symptomatic vasospasm (n=63; 28.7%) and cerebral vasospasm (n=16; 7.3%) were most frequently used to describe vasospasm (with and without ND). Vasospasm was detected using angiography (n=141; 64%), transcranial Doppler (TCD) (n=84; 38.3%) or both TCD and angiography (n=38; 17.3%). In studies involving ND (n=54), the most frequent labels were neurologic worsening (n=33; 21.4%), delayed cerebral ischemia (DCI) (n=25; 16.2%), delayed ischaemic deficit (DID) (n=25; 16.2%) and neurologic deficits (n=21; 13.6%). Criteria was not provided in most studies to differentiate ND with ischemia (DCI or DID) from ND without ischemia. Ischemia and infarction, used synonymously, were primarily measured as hypodensity on the CT. Implications for knowledge development: Inconsistent terminology and criteria for vasospasm, ND and ischemia persist over the past 25 years in studies involving a SAH. This lack of standardization places in question the results of research involving complications after a SAH.en_GB
dc.date.available2011-10-27T11:11:18Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:11:18Z-
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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