Impact of Tachycardia on Outcome After Subarachnoid Hemorrhage (SAH)
Study Details
Study Description
Brief Summary
The purpose of this retrospective study is to test the hypothesis that uncontrolled tachycardia serves as a risk factor for adverse cardiovascular events and poor outcome after Subarachnoid Hemorrhage (SAH).
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
The design of the current study will be to conduct a retrospective analysis of prolonged heart rate and uncontrolled tachycardia using patients enrolled in the investigators prospective observational cohort study since the electronic medical record systems have been implemented. The investigators know that there have been periods when these electronic systems have failed, resulting in lost data. The investigators anticipate retrospective collection of hourly heart rate for approximately 400 SAH patients that will have ICU data and 3 month modified Rankin documented in our Subarachnoid Hemorrhage Outcomes Project (SHOP) database. The investigators will determine what percent of them have prolonged elevated heart rate and tachycardia. Prolonged heart rate and uncontrolled tachycardia has been defined as a heart rate greater than 95 for greater than 12 hours in one 24 hour period of their ICU stay. The investigators will conduct a ROC curve analysis to determine the appropriate heart rate and duration thresholds that are most predictive of poor prognosis after SAH. Patients be will stratified based on several criteria including admission coma score, early (SAH day 0 to 3) or late (SAH day >=4) ICU admission, presence of intraventricular hemorrhage on admission CT, history of beta-blocker usage, age, and gender.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Subarachnoid Hemorrhage patients SAH patients with hourly eMR values of Heart Rate |
Outcome Measures
Primary Outcome Measures
- modified Rankin Scale (mRS) score [Three months]
Secondary Outcome Measures
- Prevalence of Major Adverse Cardiovascular Events (MACE) [3 months]
pulmonary edema, severe hypertension or hypotension requiring IV infusion therapy, myocardial infarction, and serious cardiac arrhythmias including sudden cardiac arrest. length of ICU and hospital stay for patients with and without uncontrolled tachycardia
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age >=18 years
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Diagnosis of subarachnoid hemorrhage established by computed tomography (CT scan) or xanthochromia of the cerebrospinal fluid if the CT is negative
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Written informed consent from either the patient or a family member
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Admitted to the NICU for at least 12 hours
Exclusion Criteria:
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Age < 18yrs
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traumatic SAH
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SAH due to a rupture of an arteriovenous malformation, neoplasm vasculitis or other secondary causes
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Columbia University Medical Center | New York | New York | United States | 10032 |
Sponsors and Collaborators
- Columbia University
- Baxter Healthcare Corporation
Investigators
- Principal Investigator: Jan Claassen, MD, Columbia University
- Study Director: J. Michael Schmidt, PhD, Columbia University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- AAAA5384