LAUSR

OBJECTIVE To retrospectively analyzed the relationship between fibrinogen and outcomes in poor-grade aneurysmal subarachnoid hemorrhage (aSAH). METHODS We recruited 66 patients with poor-grade aSAH who were treated by neurosurgical clipping between January 2010 and December 2015. Serum samples were taken immediately on admission. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between fibrinogen and clinical outcomes. RESULTS There were 19 males and 47 females included and average age of included patients was 57.2 years old. The median of admission serum fibrinogen was 3.3 g/L. Of the 66 patients, 18 patients were died at 6 months after initial hemorrhage, whereas 48 patients were survival. Multivariate analyses showed that Hunt and Hess grade Ⅴ (OR=3.89, 95% CI=1.06-14.20, p=0.04) and admission serum fibrinogen < 2.5 g/L (OR=6.15, 95% CI=1.67-22.67, p=0.006) significantly associated with 6-month mortality. In addition, admission serum fibrinogen was negatively correlated with delayed cerebral ischemia (DCI), and admission serum fibrinogen < 2.5 g/L (OR=3.86, 95% CI=0.99-15.09, p=0.05) was also significantly associated with DCI. CONCLUSIONS Poor-grade aSAH patients with reduced admission fibrinogen level have higher risk of delayed cerebral ischemia and 6-month mortality compared to those without. The admission serum fibrinogen might be useful as a predictor and treatment target in poor-grade aneurysmal subarachnoid hemorrhage patients underwent surgical treatment.