Complicaciones posteriores a hemorragia subaracnoidea espontánea en mujeres mayores a 40 años en el Hospital Abel Gilbert Pontón en el periodo 2017-2022.

Abstract

Introduction: Spontaneous subarachnoid hemorrhage (SAH) is a severe pathology characterized by bleeding in the subarachnoid space, in some cases due to the rupture of a cerebral aneurysm. It is estimated to have an annual incidence of approximately 9 cases per 100,000 people and represents a public health problem due to its high morbidity and mortality. The most frequent subsequent complications include cerebral vasospasm, seizures, and hydrocephalus. Objectives: To describe the main complications following spontaneous subarachnoid hemorrhage in women over 40 years of age treated at the Abel Gilbert Pontón Hospital between 2017 and 2022. Materials and methods: The present research has an observational, retrospective, cross-sectional design, thus not requiring prolonged follow-up or high economic resources. Electronic medical records registered in the "HOSPITAL" database system of the Abel Gilbert Pontón Hospital will be reviewed. The study will be conducted on female patients over 40 years of age admitted to the Abel Gilbert Pontón Hospital with a diagnosis of subarachnoid hemorrhage during the period 2017-2022. Results: The prevalence of complications following spontaneous subarachnoid hemorrhage was 44.1%, with vasospasm (28.3%), hydrocephalus (20.7%), and seizures (19.3%) being the most frequent. The age range with the highest prevalence was 50 to 59 years. 92.1% of patients with grade III and 100% with grade IV on the Fisher scale presented complications, in contrast to 10% in grade I and 28.1% in grade II. On the Hunt and Hess scale, complications increased from 10.4% in grade 1 to 65.5% in grade 2, 93.8% in grade 3, and 100% in grade 4. Vasospasm increased mortality by 5 times, while hydrocephalus and seizures increased the risk by 3.7 and 4 times, respectively. 92.7% of patients with vasospasm, 86.7% with hydrocephalus, and 78.6% with seizures presented disability. Discussion: The findings of this study, where vasospasm, hydrocephalus, and seizures were the most frequent complications following spontaneous subarachnoid hemorrhage in women over 40 years of age, are similar to those reported by Riveros Duré, although they differ in the distribution of grades on the Fisher and Hunt and Hess scales. However, the association found between complications, increased mortality, and disability, especially with vasospasm, contrasts with higher rates reported by previous studies such as those by Dorsch NW and Frontera. Conclusion: The study revealed a high prevalence of complications after spontaneous subarachnoid hemorrhage, with vasospasm being the most frequent, especially in women aged 50 to 59 years. The Fisher and Hunt and Hess scales demonstrated their utility in predicting the risk of complications, which were significantly associated with an increase in mortality and disability, highlighting vasospasm as the factor with the greatest negative impact.