Preventive Antibiotics and Delayed Cerebral Ischaemia in Patients with Aneurysmal Subarachnoid Haemorrhage Admitted to the Intensive Care Unit
| العنوان: | Preventive Antibiotics and Delayed Cerebral Ischaemia in Patients with Aneurysmal Subarachnoid Haemorrhage Admitted to the Intensive Care Unit |
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| المؤلفون: | Walter M. van den Bergh, Diederik van de Beek, Celine S. Gathier, W. Peter Vandertop, Anne Marie G. A. de Smet, Dagmar Verbaan, Sanne M. Dorhout Mees, Gabriel J.E. Rinkel, Ale Algra, Mervyn D.I. Vergouwen, Marc J. M. Bonten, Evelien A. N. Oostdijk |
| المساهمون: | Experimental Vascular Medicine, Neurology, Amsterdam institute for Infection and Immunity, Amsterdam Neuroscience - Neurovascular Disorders, Neurosurgery, Amsterdam Cardiovascular Sciences, Other departments, Microbes in Health and Disease (MHD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
| المصدر: | Neurocritical Care, 24(1), 122. Humana Press Neurocritical care, 24(1), 122-127. Humana Press Gathier, C S, Oostdijk, E A, Rinkel, G J E, Dorhout Mees, S M, Vergouwen, M D I, de Smet, A M G A, van de Beek, D, Vandertop, W P, Verbaan, D, Algra, A, Bonten, M J M & van den Bergh, W M 2016, ' Preventive Antibiotics and Delayed Cerebral Ischaemia in Patients with Aneurysmal Subarachnoid Haemorrhage Admitted to the Intensive Care Unit ', Neurocritical care, vol. 24, no. 1, pp. 122-7 . https://doi.org/10.1007/s12028-015-0202-1Test Neurocritical care, 24(1), 122-7. Humana Press |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Male, VASOSPASM, Critical Care and Intensive Care Medicine, Brain Ischemia, law.invention, DECONTAMINATION, 0302 clinical medicine, law, Antibiotics, Outcome Assessment, Health Care, 030212 general & internal medicine, Young adult, Non-U.S. Gov't, Aneurysmal subarachnoid haemorrhage, Aged, 80 and over, Research Support, Non-U.S. Gov't, Hazard ratio, Case-control study, Vasospasm, Middle Aged, Intensive care unit, Anti-Bacterial Agents, 3. Good health, Intensive Care Units, MEDICAL COMPLICATIONS, Delayed cerebral ischaemia, Female, Adult, OROPHARYNX, medicine.medical_specialty, Case–control study, Clinical Neurology, Research Support, Young Adult, 03 medical and health sciences, Internal medicine, Intensive care, medicine, Journal Article, Humans, Intensive care medicine, Aged, Retrospective Studies, business.industry, Intracranial Aneurysm, Retrospective cohort study, Subarachnoid Hemorrhage, medicine.disease, Case-Control Studies, Relative risk, Neurology (clinical), business, 030217 neurology & neurosurgery, TRACT |
| الوصف: | INTRODUCTION: Delayed cerebral ischemia (DCI) is an important contributor to poor outcome after aneurysmal subarachnoid haemorrhage (aSAH). Development of DCI is multifactorial, and inflammation, with or without infection, is one of the factors independently associated with development of DCI and poor outcome. We thus postulated that preventive antibiotics might be associated with a reduced risk of DCI and subsequent poor outcome in aSAH patients.METHODS: We performed a retrospective cohort-study in intensive care units (ICU) of three university hospitals in The Netherlands. We included consecutive aSAH patients with minimal ICU stay of 72 h who received either preventive antibiotics (SDD: selective digestive tract decontamination including systemic cefotaxime or SOD: selective oropharyngeal decontamination) or no preventive antibiotics. DCI was defined as a new hypodensity on CT with no other explanation than DCI. Hazard ratio's (HR) for DCI and risk ratio's (RR) for 28-day case-fatality and poor outcome at 3 months were calculated, with adjustment (aHR/aRR) for clinical condition on admission, recurrent bleeding, aneurysm treatment modality and treatment site.RESULTS: Of 459 included patients, 274 received preventive antibiotics (SOD or SDD) and 185 did not. With preventive antibiotics, the aHR for DCI was 1.0 (95 % CI 0.6-1.8), the aRR for 28-day case-fatality was 1.1 (95 % CI 0.7-1.9) and the aRR for poor functional outcome 1.2 (95 % CI 1.0-1.4).CONCLUSIONS: Preventive antibiotics were not associated with reduced risk of DCI or poor outcome in aSAH patients in the ICU. |
| وصف الملف: | image/pdf |
| اللغة: | English |
| تدمد: | 1541-6933 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c579d0374c7cdb546c689bdb96bcda54Test https://dspace.library.uu.nl/handle/1874/333658Test |
| حقوق: | RESTRICTED |
| رقم الانضمام: | edsair.doi.dedup.....c579d0374c7cdb546c689bdb96bcda54 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15416933 |
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