IMPACT OF TRAUMATIC SUBARACHNOID HEMORRHAGE ON OUTCOME IN NONPENETRATING HEAD-INJURY .2. RELATIONSHIP TO CLINICAL COURSE AND OUTCOME VARIABLES DURING ACUTE HOSPITALIZATION

Patients with a nonpenetrating head injury and traumatic subarachnoid hemorrhage (tSAH) on admission head computed tomography scan (n = 240) were compared with patients without tSAH matched in terms of admissio n postresuscitation Glasgow Coma Scale (GCS) values. age, ses, and the presence of orae or more types of intracranial mass lesions, Admissio n Injury Severity Score was higher only in tSAH patients with admissio n GCS scores between 13 and 15; GCS values at 6, 24, and 48 hours were lower for tSAH patients. Patients with tSAH underwent fewer craniotom ies, but more than twice as many tSAH patients had high intracranial p ressure at the time of ventriculostomy placement and 6 hours after adm ission, tSAH patients underwent more chest procedures and their incide nce of hypoxia and hypotension was greater, tSAH patients spent more d ays in intensive care unit, more total days hospitalized, and had wors e Glasgow Outcome Scale scores at acute hospital discharge. Fewer tSAH patients were discharged home, and almost 1.5 times as many tSAH pati ents died during hospitalization. Given a similar overall degree of in jury at admission, patients with tSAH associated with a nonpenetrating head injury had a worse outcome than similar patients without tSAH.