Whether the use of fludrocortisone affects outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH). We conducted a retrospective analysis of 78 consecutive patients with a ruptured aSAH at a single academic center in the United States. The primary outcome was the score on the modified Rankin scale (mRS, range, 0 [no symptoms] to 6 [death]) at 90 days. The primary outcome was adjusted for age, hypertension, aSAH grade, and time from aSAH onset to aneurysm treatment. Secondary outcomes were neurologic and cardiopulmonary dysfunction events. Among 78 patients at a single center, the median age was 58 years [IQR, 49 to 64.5]; 64% were female, and 41 (53%) received fludrocortisone. The adjusted common odds ratio, aOR, of a proportional odds regression model of fludrocortisone use with mRS was 0.33 (95% CI, 0.14-0.80; P=0.02), with values <1.0 favoring fludrocortisone. Organ-specific dysfunction events were not statistically different: delayed cerebral ischemia (22% vs. 39%, P=0.16); cardiac dysfunction (0% vs. 11%; P=0.10); and pulmonary edema (15% vs. 8%; P=0.59). The risk of disability or death at 90 days was lower with the use of fludrocortisone in aSAH patients.

中文翻译：

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氟氢可的松对蛛网膜下腔出血患者预后的影响：回顾性分析

氟氢可的松的使用是否会影响动脉瘤性蛛网膜下腔出血（aSAH）患者的预后。我们对美国一个学术中心连续 78 名 aSAH 破裂患者进行了回顾性分析。主要结局是 90 天时改良 Rankin 量表的评分（mRS，范围，0 [无症状] 至 6 [死亡]）。主要结局根据年龄、高血压、aSAH 分级以及从 aSAH 发病到动脉瘤治疗的时间进行调整。次要结局是神经系统和心肺功能障碍事件。在单个中心的 78 名患者中，中位年龄为 58 岁 [IQR，49 至 64.5]；64% 为女性，其中 41 人 (53%) 接受氟氢可的松治疗。氟氢可的松与 mRS 结合使用的比例优势回归模型的调整共同优势比 (aOR) 为 0.33（95% CI，0.14-0.80；P=0.02），值 <1.0 有利于氟氢可的松。器官特异性功能障碍事件无统计学差异：迟发性脑缺血（22% vs. 39%，P=0.16）；心功能不全（0% vs. 11%；P=0.10）；和肺水肿（15% vs. 8%；P=0.59）。aSAH 患者使用氟氢可的松后 90 天残疾或死亡的风险较低。