Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage

© The Author(s) 2018. Background: Guidelines for aneurysm subarachnoid hemorrhage (aSAH) management recommend treatment with nimodipine to all patients to reduce delayed cerebral ischemia (DCI) and poor clinical outcome. However, it did not give the most beneficial time to start therapy and route of...

Full description

Saved in:
Bibliographic Details
Main Authors: Tipada Samseethong, Thanarat Suansanae, Kullapat Veerasarn, Anusak Liengudom, Chuthamanee Suthisisang
Other Authors: Ubon Rajathanee University
Format: Article
Published: 2019
Subjects:
Online Access:https://repository.li.mahidol.ac.th/handle/123456789/46215
Tags: Add Tag
No Tags, Be the first to tag this record!
Institution: Mahidol University
id th-mahidol.46215
record_format dspace
spelling th-mahidol.462152019-08-23T18:37:55Z Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage Tipada Samseethong Thanarat Suansanae Kullapat Veerasarn Anusak Liengudom Chuthamanee Suthisisang Ubon Rajathanee University Mahidol University Vichaiyut Hospital Prasat Neurological Institute Medicine © The Author(s) 2018. Background: Guidelines for aneurysm subarachnoid hemorrhage (aSAH) management recommend treatment with nimodipine to all patients to reduce delayed cerebral ischemia (DCI) and poor clinical outcome. However, it did not give the most beneficial time to start therapy and route of administration. Objectives: To compare the DCI occurrence and clinical outcome among aSAH patients who received nimodipine treatment at different times. Methods: A retrospective cohort study was conducted by collecting data from medical chart reviews between August 30, 2010, and October 31, 2015, at Prasart Neurological Institute, Thailand. Patients were classified into 2 groups by time to receive nimodipine: early group and late group (<96 and >96 hours, respectively). All patients received intravenous (IV) followed by oral nimodipine to complete treatment course. Clinical outcome was graded using the Glasgow Outcome Scale at 21 days. The factors related to DCI were analyzed using multivariate logistic regression. Results: A total of 149 patients were recruited: early (n = 97) and late (n = 52). No difference in baseline characteristics between groups was observed. The occurrence of DCI was not statistically significantly different between groups (early group, 18.60%, vs late group, 20.80%; P = 0.74). The World Federation of Neurosurgical Societies IV to V was associated with DCI occurrence. The proportion of patients with good outcome, poor outcome, or death did not show any difference between groups. Conclusions and Relevance: Receiving IV nimodipine 3 to 7 days following oral therapy after bleeding can be the alternative regimen in patients who did not start nimodipine within 96 hours. 2019-08-23T11:37:55Z 2019-08-23T11:37:55Z 2018-11-01 Article Annals of Pharmacotherapy. Vol.52, No.11 (2018), 1061-1069 10.1177/1060028018778751 15426270 10600280 2-s2.0-85047405965 https://repository.li.mahidol.ac.th/handle/123456789/46215 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047405965&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Tipada Samseethong
Thanarat Suansanae
Kullapat Veerasarn
Anusak Liengudom
Chuthamanee Suthisisang
Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
description © The Author(s) 2018. Background: Guidelines for aneurysm subarachnoid hemorrhage (aSAH) management recommend treatment with nimodipine to all patients to reduce delayed cerebral ischemia (DCI) and poor clinical outcome. However, it did not give the most beneficial time to start therapy and route of administration. Objectives: To compare the DCI occurrence and clinical outcome among aSAH patients who received nimodipine treatment at different times. Methods: A retrospective cohort study was conducted by collecting data from medical chart reviews between August 30, 2010, and October 31, 2015, at Prasart Neurological Institute, Thailand. Patients were classified into 2 groups by time to receive nimodipine: early group and late group (<96 and >96 hours, respectively). All patients received intravenous (IV) followed by oral nimodipine to complete treatment course. Clinical outcome was graded using the Glasgow Outcome Scale at 21 days. The factors related to DCI were analyzed using multivariate logistic regression. Results: A total of 149 patients were recruited: early (n = 97) and late (n = 52). No difference in baseline characteristics between groups was observed. The occurrence of DCI was not statistically significantly different between groups (early group, 18.60%, vs late group, 20.80%; P = 0.74). The World Federation of Neurosurgical Societies IV to V was associated with DCI occurrence. The proportion of patients with good outcome, poor outcome, or death did not show any difference between groups. Conclusions and Relevance: Receiving IV nimodipine 3 to 7 days following oral therapy after bleeding can be the alternative regimen in patients who did not start nimodipine within 96 hours.
author2 Ubon Rajathanee University
author_facet Ubon Rajathanee University
Tipada Samseethong
Thanarat Suansanae
Kullapat Veerasarn
Anusak Liengudom
Chuthamanee Suthisisang
format Article
author Tipada Samseethong
Thanarat Suansanae
Kullapat Veerasarn
Anusak Liengudom
Chuthamanee Suthisisang
author_sort Tipada Samseethong
title Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
title_short Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
title_full Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
title_fullStr Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
title_full_unstemmed Impact of Early Versus Late Intravenous Followed by Oral Nimodipine Treatment on the Occurrence of Delayed Cerebral Ischemia Among Patients With Aneurysm Subarachnoid Hemorrhage
title_sort impact of early versus late intravenous followed by oral nimodipine treatment on the occurrence of delayed cerebral ischemia among patients with aneurysm subarachnoid hemorrhage
publishDate 2019
url https://repository.li.mahidol.ac.th/handle/123456789/46215
_version_ 1763489527689641984