BACKGROUND Hypozincaemia may develop in critically ill patients, including those with acute brain injury in the early phase after hospital admission. The aim of this study was to investigate the prevalence of hypozincaemia after aneurysmal subarachnoid haemorrhage (aSAH) and its association with delayed cerebral ischemia and functional outcome. METHODS We retrospectively analysed a cohort of 384 patients with SAH admitted to the Neurointensive Care Unit at Rigshospitalet, Copenhagen, Denmark, in whom at least one measurement of plasma zinc concentration was done during the hospital stay. Hypozincaemia was defined as at least one measurement of plasma zinc below 10 μmol/L. Potential associations between hypozincaemia, demographic variables and functional outcome after aSAH were analysed in multivariable logistic regression models. RESULTS Hypozincaemia was observed in 67% (n = 257) of all patients and occurred within 7 days in more than 95% of all hypozincaemic patients. In a multivariable model, severe SAH (WFNS 3-5; OR 4.2, CI 2.21-8.32, p < 0.001) and Sequential Organ Failure Assessment (SOFA) score on the day of admission (OR 1.24, CI 1.11-1.40, p < 0.001) were independently associated with hypozincaemia. In another multivariable model, hypozincaemia was independently associated with an unfavourable outcome (defined as a modified Rankin Scale score from 3 to 6) (OR 1.97, CI 1.06-3.68, p = 0.032), as was age (OR 1.03, CI 1.01-1.05, p = 0.015), SOFA score on the day of admission (OR 1.14, CI 1.02-1.29, p = 0.02), a diagnosis of delayed cerebral ischaemia (OR 4.06, CI 2.29-7.31, p < 0.001) and a clinical state precluding assessment for delayed cerebral ischaemia (OR 15.13, CI 6.59-38.03, p < 0.001). CONCLUSION Hypozincaemia occurs frequently after aSAH, is associated with a higher disease severity and independently contributes to an unfavourable outcome.

中文翻译：

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低氧血症与动脉瘤性蛛网膜下腔出血的严重程度有关：一项回顾性队列研究。

背景低氧血症可能发生在危重患者中，包括那些在入院后早期患有急性脑损伤的患者。这项研究的目的是调查动脉瘤性蛛网膜下腔出血（aSAH）后低锌血症的患病率及其与延迟性脑缺血和功能预后的关系。方法我们回顾性分析了丹麦哥本哈根Rigshospitalet神经重症监护病房收治的384例SAH患者，他们在住院期间至少进行了一次血浆锌浓度的测量。低氧血症被定义为至少一项血浆锌含量低于10μmol/ L的测量。在多变量logistic回归模型中分析了aSAH后低锌血症，人口统计学变量和功能结局之间的潜在关联。结果在所有患者中有67％（n = 257）观察到低氧血症，在所有95％的低锌血症患者中7天之内就发生了低氧血症。在多变量模型中，入院当天严重SAH（WFNS 3-5; OR 4.2，CI 2.21-8.32，p <0.001）和序贯器官衰竭评估（SOFA）评分（OR 1.24，CI 1.11-1.40，p < 0.001）与低锌血症独立相关。在另一个多变量模型中，低锌血症与不良结局（定义为3到6的改良Rankin量表评分）独立相关（OR 1.97，CI 1.06-3.68，p = 0.032），年龄也是如此（OR 1.03，CI 1.01- 1.05，p = 0.015），入院当天的SOFA评分（OR 1.14，CI 1.02-1.29，p = 0.02），诊断为迟发性脑缺血（OR 4.06，CI 2.29-7.31，p <0。001）和临床状态排除评估，以评估迟发性脑缺血（OR 15.13，CI 6.59-38.03，p <0.001）。结论低氧血症在aSAH后经常发生，与疾病严重程度较高相关，并且独立地导致不良结局。