Risk factors for aneurysmal subarachnoid hemorrhage patients with neurogenic pulmonary edema

ObjectiveTo explore the incidence and risk factors of neurogenic pulmonary edema (NPE) in patients with aneurysmal subarachnoid hemorrhage (aSAH) in early stage.

MethodsA retrospective analysis was conducted on 115 patients with aSAH, and clinical data was collected.According to whether NPE occurred within 24 h from admission, they were divided into the group with NPE and the group without NPE.Univariate analysis was used to compare the differences in clinical data and outcomes between two groups, and multivariate logistic regression analysis was used to reveal the independent risk factors for NPE, and the predictive efficacy was evaluated using receiver operating characteristic (ROC) curve.

ResultsFourteen patients (12.2%) presented with NPE within 24 h from admission.Hunt-Hess grade Ⅳ-Ⅴ, elevated troponin Ⅰ, and aneurysm location (posterior circulation) were independent risk factors of NPE in patients with aSAH within 24 h from admission (P < 0.05).The ROC curve analysis results showed that the combined detection factor model of the above three factors predicted the area under the curve for NPE in aSAH patients was 0.828 (95%CI: 0.693-0.963), with a sensitivity of 64.3% and a specificity of 92.1%, which was superior to various single indicators.

ConclusionsPatients with ruptured aneurysm in the posterior circulation was a significant risk factor for NPE in patients with aSAH, frequently with more severe clinical grade and elevated troponin I at admission.Clinically, such patients should be highly vigilant.