Abstract
Background: Delays in initial treatment or hospitalization have been reported to lead to poor prognoses in patients with a subarachnoid hemorrhage (SAH), and thus the prompt transport of SAH patients to appropriate institutions is required. The stress index (SI, calculated as blood sugar level/potassium level) is thought to correlate with shifts in the catecholamine level of patients with SAH, in whom high SI values have been observed from the early onset period. The SI can be determined from simple examinations such as a blood gas analysis. We examined the usability of the SI in the early diagnosis of SAH.
Patients and Methods: We retrospectively analyzed the records of 316 patients who were transported to the emergency department of a local core hospital over the 2‒year period from March 2015 through February 2017. Patients were assigned to the SAH group (n＝34) or the non‒SAH group (n＝282), and their background and SI values were compared.
Results: The SI value was significantly higher in the SAH group than the non‒SAH group (50.8 vs. 38.9, p＜0.001). A receiver operating characteristic curve analysis resulted in moderate accuracy when the SI cut‒off point was set at 44: 70% sensitivity, 73% specificity, and 0.741 area under the curve (95% confidence interval: 0.668‒0.814). A multivariable analysis revealed an SI value that was 9.5‒fold higher in the SAH group.
Conclusion: Our findings suggest that use of the SI value could contribute to the decision‒making process for SAH at the transfer institution when used in combination with other clinical observations.
