Abstract P444: Myocardial Infarction and Subarachnoid Hemorrhage. Frequency and Impact on Outcome

Abstract

Introduction/background: Subarachnoid hemorrhage is known to be associated with systemic complications including neurogenic pulmonary edema and Talkotsubo cardiomyopathy. We set to establish the frequency of myocardial infarction (MI) and its impact on outcome among patients with subarachnoid hemorrhage (SAH) Methods: We analyzed the data from Nationwide Inpatient Sample (2005-2014) for all subarachnoid hemorrhage (ICH) patients. Myocardial infraction (MI) was identified using the International Classification of Disease, 9th Revision, Clinical Modification codes. Baseline characteristics, discharge outcomes (mortality, moderate to severe disability at dischagre, length of stay and in-hospital charges) were compared between the two groups. Results: Of the 325923 patients with SAH, 12720 (3.90%) had in-hospital myocardial infraction. SAH patients with MI were older (64.6 years versus 59.0 years, P <.0001) compared to SAH patients without MI but there was no difference in-term of proportion of females between the two groups. The in-hospital mortality was also higher (49.8% versus 23.9%, p≤.0001) among patients with MI in both univariate and multivariate analysis (OR = 1.75 (1.59 -1.93), P<.0001) after adjusting for potential confounders. SAH patients with MI had higher (68.5% versus 40.9%, P <.0001) proportion of moderate to severe disability at discharge compared to ones without. Similarly, mean length of in-hospital stay (13.2 days versus 11.8 days, P <.0001) and mean hospital charges ($188845 versus $150062, P <.0001) were also higher in SAH patients with MI Conclusions: While MI was reported in only 3.9% of SAH cases it had a significant impact on outcome with a one fold increase in morality and about 75% increase risk of severe disability.