Key Predictors of Cerebral Vasospasm Following Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.
Jung Min Lee, Wonkyung Jung, Sun-Mi Lee
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In 30 seconds
This systematic review and meta-analysis examined observational evidence on factors associated with cerebral vasospasm after subarachnoid hemorrhage (SAH). The review included 38 studies, with 27 contributing to the meta-analysis and 19 033 patients overall. Clinical severity measures and hemodynamic status showed the strongest associations with vasospasm: Modified Fisher grade had an odds ratio (OR) of 2.88 (95% CI, 2.04-4.07), Fisher grade an OR of 2.27 (95% CI, 1.91-2.69), and hemodynamic status an OR of 2.56 (95% CI, 1.17-5.59).
Key findings
- Modified Fisher grade was associated with cerebral vasospasm (OR = 2.88; 95% CI, 2.04-4.07).
- Fisher grade was associated with cerebral vasospasm (OR = 2.27; 95% CI, 1.91-2.69).
- Hemodynamic status was associated with cerebral vasospasm (OR = 2.56; 95% CI, 1.17-5.59).
- Aneurysm-related factors and comorbid conditions were associated with increased risk; clinical and inflammatory biomarkers had relatively smaller effect sizes.
Why it matters
The findings identify clinical severity scales and hemodynamic status as useful markers of vasospasm risk after SAH. Recognising these associations can inform early risk assessment and structured monitoring in intensive care, where vasospasm is linked to delayed cerebral ischemia and increased mortality. The evidence synthesises observational studies, so it supports risk stratification rather than establishing that these factors cause vasospasm.
What to keep in mind
The evidence came from observational studies, so associations do not establish causation. The abstract does not report further limitations.