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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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The effects of ABO blood type on subarachnoid haemorrhage

Der Einfluss der ABO Blutgruppe auf Subarachnoidalblutungen

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  • Markus Strey - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Lübeck, Deutschland
  • Jan Küchler - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Lübeck, Deutschland
  • Claudia Ditz - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Lübeck, Deutschland
  • Volker M. Tronnier - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Lübeck, Deutschland
  • presenting/speaker Kara Krajewski - Universitätsklinikum Schleswig-Holstein, Neurochirurgie, Lübeck, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV021

doi: 10.3205/20dgnc026, urn:nbn:de:0183-20dgnc0260

Published: June 26, 2020

© 2020 Strey et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The O blood type has been shown to be significantly associated with mortality in patients with severe trauma injury in major series. Pathophysiologically, vWF levels in type O patients are known to be reduced. Few studies exist on the effects of blood type on subarachnoid hemorrhage (SAH), especially after correcting for anticoagulant use. The aim of this study was to examine the effects of blood type after correcting for anticoagulant use on Hunt and Hess grade, vasospasm, shunting, mortality and unfavorable outcome according to the modified rankin scale (mRS).

Methods: A retrospective analysis of all consecutive SAH patients treated at our single university center from 2007-2017 was performed. Data were acquired from the electronic patient chart and discharge summaries. Questionnaires were sent to all patients regarding anticoagulant use. For further analysis, the following variables were dichotomized: Hunt and Hess grade (I-II: "low", III-V: "high") as well as mRS (0-2: "favorable", 3-6: "unfavorable"). Logistic regression was performed with SPSS. Analyses were carried out for aneurysmal and non-aneurysmal cohorts separately. P values < 0.05 were considered significant. Results are presented as odds ratio with 95% confidence intervals.

Results: A total of 397 patients (median age: 55y) were included. 315 patients had angiographic confirmation of aneurysm, 82 were non-aneurysmal. For aneurysmal SAH, risk factors for vasospasm were decreasing age (OR 0.98, CI: 95.7-99.7, p=0.023) and high H&H grade (OR 1.8, CI: 1.1-3.0, p=0.022) but not blood type O or anticoagulant use. Unfavorable outcome at 6 months was also not associated with blood type or anticoagulants. Among high-grade H&H patients, only blood type O was associated with a lower OR for death (OR 0.383, CI:0.185-0.792, P=0.010). Excluding patients with a history of anticoagulant use did not change any findings.

For the naSAH group, high H&H grade was highly associated with poor outcome at 3 months (OR 73.9, CI: 4.3-1254.7, p=0.003). No risk factors were identified for outcome at 6 months, death (n=5 patients), vasospasm, vasospastic infarction or shunt. Excluding anticoagulant use had no effect.

Conclusion: Blood type O may lower the risk of death for high-grade aSAH patients. We found a history of anticoagulant use has no effects on H&H grade, vasospasm, or outcome incl. death. Few predictive factors exist for naSAH patients with respect to outcome.