Impact of Implementing an Elaborated CT Perfusion Protocol for Aneurysmal SAH on Functional Outcome: CTP Protocol for SAH

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FIG 1.
Flow chart of the CTP protocol. BFV indicates blood flow velocity.
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FIG 2.
Incidence of vasospasm and ischemic complications in both groups, showing no significant difference for either DIND or delayed infarction.
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FIG 3.
Examples of large territorial and multiple infarctions (A and B) and smaller infarctions affecting only a part of a vessel territory (C and D).
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FIG 4.
Comparison of functional outcome (mRS at 3 months’ follow-up) showing significantly better functional outcome in group 2 compared with group 1 (Mann-Whitney U test, P = .0005).

Table 1:

Baseline characteristics in both patient groups

Characteristics	Group 1	Group 2	P Value
No. of patients	57	76
Mean age (range) (yr)	53.3 (SD, 15.2) (21–84)	54.4 (SD, 12.9) (29–86)	.64
Sex
Male (%)	21/57 (36.8%)	21/76 (27.6%)	.26
Female (%)	36/57 (63.2%)	55/76 (72.4%)
WFNS grade
I–III (%)	28/57 (49.1%)	42/76 (55.3%)	.48
IV–V (%)	29/57 (50.9%)	34/76 (44.7%)	.41
Mean (95% CI)	3.1 (2.7–3.6)	2.9 (2.5–3.2)
Fisher grade
1–2 (%)	7/57 (12.3%)	8/76 (10.5%)	.75
3–4 (%)	50/57 (87.7%)	68/76 (89.5%)	.97
Mean (95% CI)	3.4 (3.2–3.6)	3.4 (3.3–3.6)
Multiple aneurysms	12/57 (21.1%)	18/76 (23.7%)	.72
Aneurysm location
Anterior incl. posterior communicating artery	46/57 (80.7%)	64/76 (84.2%)	.59
Posterior	11/57 (19.3%)	12/76 (15.8%)
Aneurysm treatment
Clipping	34/57 (59.6%)	44/76 (57.9%)	.84
Coiling	23/57 (40.4%)	32/76 (42.1%)

Table 2:

Multivariate analysis for prediction of functional outcome at 3 months’ follow-up

Variables	Estimate	SD (95% CI)	t	P Value
Age	0.05746	0.01000 (0.03766–0.07725)	5.743	<.001^{^a}
WFNS grade	0.5963	0.09633 (0.4057–0.7869)	6.191	<.001^{^a}
Fisher grade	0.2520	0.2206 (−0.1850–0.6890)	1.142	.25
Delayed infarction	1.827	0.3828 (1.070–2.585)	4.773	<.001^{^a}
CTP protocol	−0.9287	0.2728 (−1.469–0.3889)	3.406	<.001^{^b}
ERT	−0.6650	0.4308 (−1.517–0.1876)	1.544	.12

Table 3:

Multivariate analysis for prediction of delayed, large territorial and/or multiple infarctions

Variables	Estimate	SD (95% CI)	t	P Value
CT protocol	−0.1070	0.0512 (−0.2084–0.0055)	2.088	.03^{^a}
WFNS grade	0.5963	0.09633 (0.4057–0.7869)	6.191	.01^{^a}
Fisher grade	0.0080	0.0412 (0.0896–0.0735)	0.1956	.84
DIND	0.0637	0.0733 (−0.0814–0.2089)	0.8692	.38
ERT	−0.6650	0.4308 (−1.517-0.1876)	1.544	.12