Impact of Tachycardia on Outcome After Subarachnoid Hemorrhage (SAH)
Impact of Tachycardia on Outcome After Subarachnoid Hemorrhage (SAH)
The purpose of this retrospective study is to test the hypothesis that uncontrolled
 tachycardia serves as a risk factor for adverse cardiovascular events and poor outcome after
 Subarachnoid Hemorrhage (SAH).
The design of the current study will be to conduct a retrospective analysis of prolonged
 heart rate and uncontrolled tachycardia using patients enrolled in the investigators
 prospective observational cohort study since the electronic medical record systems have been
 implemented. The investigators know that there have been periods when these electronic
 systems have failed, resulting in lost data. The investigators anticipate retrospective
 collection of hourly heart rate for approximately 400 SAH patients that will have ICU data
 and 3 month modified Rankin documented in our Subarachnoid Hemorrhage Outcomes Project (SHOP)
 database. The investigators will determine what percent of them have prolonged elevated heart
 rate and tachycardia. Prolonged heart rate and uncontrolled tachycardia has been defined as a
 heart rate greater than 95 for greater than 12 hours in one 24 hour period of their ICU stay.
 The investigators will conduct a ROC curve analysis to determine the appropriate heart rate
 and duration thresholds that are most predictive of poor prognosis after SAH. Patients be
 will stratified based on several criteria including admission coma score, early (SAH day 0 to
 3) or late (SAH day >=4) ICU admission, presence of intraventricular hemorrhage on admission
 CT, history of beta-blocker usage, age, and gender.
Inclusion Criteria:

 -  Age >=18 years

 -  Diagnosis of subarachnoid hemorrhage established by computed tomography (CT scan) or
 xanthochromia of the cerebrospinal fluid if the CT is negative

 -  Written informed consent from either the patient or a family member

 -  Admitted to the NICU for at least 12 hours

 Exclusion Criteria:

 -  Age < 18yrs

 -  traumatic SAH

 -  SAH due to a rupture of an arteriovenous malformation, neoplasm vasculitis or other
 secondary causes