Formal Project Prize Session

Effects of Fluid Balance on Outcome of Patients with Aneurysmal Subarachnoid Haemorrhage

Beatrice Hoi-Ying LAI
Department of Anaesthesia and Intensive Care, Prince of Wales hospital, Hong Kong

Objective: Aneurysmal subarachnoid haemorrhage (SAH) is a neurosurgical emergency. Fluid management in SAH patients remains a challenge. Thus, this study aimed to determine whether early fluid balance can affect functional outcome.

Design: Retrospective study

Setting: Intensive Care Unit (ICU) of Pamela Youde Nethersole Eastern Hospital in Hong Kong (January 2011 to December 2016)

Participants: A total of 140 aneurysmal SAH patients were included in the analysis and divided into the poor outcome group (n=77) and good outcome group (n=63).

Main outcome measures: Glasgow Outcome Scale (GOS) at 3 months with GOS 1-3 was classified as poor outcome and GOS 4-5 as good outcome. Secondary outcomes were ventilator days, hospital and ICU length of stay (LOS). Modified Fisher scale and APACHE IV score were recorded.

Results: The 4-day cumulative fluid balance was 1474 (349-2623.5) ml in the poor outcome group and 274 (-1158 to 1615) ml in the good outcome group. On univariate analysis, 4-day cumulative fluid balance was associated with poor outcome (P=0.002) but was not an independent predictor of poor outcome. Modified Fisher scale 4 (odds ratio (OR)=6.908, 95% confidence interval (CI), 1.117-42.704. P=0.038), age (OR=1.087, 95% CI, 1.047-1.128, P< 0.01), and APACHE IV score (OR=1.024, 95% CI, 1.006-1.042, P=0.01) were independent predictors of poor outcome. The 4-day cumulative fluid balance was not associated with ICU LOS (Spearman’s rho correlation coefficient, r=0.152, P=0.073), hospital LOS (r=0.126, P=0.137) and ventilator days (r=0.252, P=0.003).

Conclusion: Fluid balance is not an independent predictor of poor outcome in SAH patients.

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