Assessment of stress index in patients with subarachnoid hemorrhage of acute phase

Abstract

Background and Purpose: Subarachnoid hemorrhage (SAH) in an acute phase causes increase in serum catecholamine concentration, which is well associated with stress index (SI) calculated as serum glucose (Glu) divided by potassium (K). The purpose of this study was to analyze the relationship between SI and severity of SAH, and SI and patient’s outcome. Methods: We collected SAH patient’s clinical data (including K and Glu on arrival) from two institutes for the past four years. We divided SAH patients into two groups based on severity of SAH and patient’s outcome. K, Glu, and SI were compared between the two groups. Results: We retrospectively analyzed 122 SAH patients. Glu and SI were significantly higher (p < 0.01 for both Glu and SI) in the severe (n=66) and poor outcome (n=62) groups than in the moderate (n=56) and good outcome (n=60) groups. In World Federation of Neurological Surgeons grade V patients, the receiver operating characteristics assessment revealed that the good outcome group could be detected by SI ≤56.00. Conclusion: SI might be simply used as a prognosis predicting factor in clinical situations.