Impact of fludrocortisone on the outcomes of subarachnoid hemorrhage patients: A retrospective analysis.

Background: Whether the use of fludrocortisone affects outcomes of patients with aneurysmal subarachnoid hemorrhage (aSAH).
Methods: We conducted a retrospective analysis of 78 consecutive patients with a ruptured aSAH at a single academic center in the United States. The primary outcome was the score on the modified Rankin scale (mRS, range, 0 [no symptoms] to 6 [death]) at 90 days. The primary outcome was adjusted for age, hypertension, aSAH grade, and time from aSAH onset to aneurysm treatment. Secondary outcomes were neurologic and cardiopulmonary dysfunction events.
Results: Among 78 patients at a single center, the median age was 58 years [IQR, 49 to 64.5]; 64 % were female, and 41 (53 %) received fludrocortisone. The adjusted common odds ratio, aOR, of a proportional odds regression model of fludrocortisone use with mRS was 0.33 (95 % CI, 0.14-0.80; P = 0.02), with values <1.0 favoring fludrocortisone. Organ-specific dysfunction events were not statistically different: delayed cerebral ischemia (22 % vs. 39 %, P = 0.16); cardiac dysfunction (0 % vs. 11 %; P = 0.10); and pulmonary edema (15 % vs. 8 %; P = 0.59).
Conclusions: The risk of disability or death at 90 days was lower with the use of fludrocortisone in aSAH patients.
Competing Interests: Declaration of competing interest Isaac Abecassis has the following disclosures: 1) Remedy Robotics: Consultant, Equity. 2) IschemaView Inc/Rapid AI: Clinical consultant. 3) Rapid Medical: Consultant. 4) Balt: Consultant. 5) CNS Foundation: Grant Research Support.
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