GIÁ TRỊ TIÊN LƯỢNG CỦA HẠ NATRI MÁU VÀ YẾU TỐ LÂM SÀNG TRONG CHẢY MÁU DƯỚI NHỆN DO VỠ PHÌNH MẠCH NÃO

Abstract

Objectives: To evaluate the association between hyponatremia and short-term neurological outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods: This cross-sectional study included 428 patients with aSAH. We collected data on clinical characteristics, imaging findings (WFNS and Fisher grades), history of hypertension, and serum sodium levels. Neurological outcomes were assessed using the Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) at discharge and 30 days. Univariate and multivariate logistic regression analyses were performed. Results: Univariate analysis indicated a significant positive association between serum sodium levels and neurological outcomes, particularly with GOS at discharge (OR = 1.083; p = 0.01). However, after adjusting for confounding factors (WFNS grade, Fisher grade, and hypertension) in the multivariate model, hyponatremia was not an independent predictor of good neurological outcome (OR = 0.612; p = 0.069). Admission WFNS grade remained the strongest independent prognostic factor (p < 0.001). Conclusion: Although hyponatremia correlates with neurological status, it has limited independent prognostic value for short-term outcomes in aSAH patients compared to initial clinical severity. The WFNS grade upon admission remains the most critical predictor.