1018 RUPTURED CEREBRAL ANEURYSM AND OBSTRUCTIVE SLEEP APNEA: IS ANY LINK THERE?

Abstract Introduction: Obstructive sleep apnea (OSA) is associated with the progression of abdominal and thoracic aortic aneurysms. However, the role of OSA in the overall outcome of intracranial ruptured aneurysms (RIAs) has not yet been known. We have investigated the role of OSA in overall outcome of RIAs. Methods: Data of 159 consecutive patients were retrospectively reviewed. In this series, we have performed Chi square test to determine the significant difference between two groups. Regression analysis was conducted to identify the predictors of unfavorable outcome of ruptured intracranial aneurysms. A p value of less than 0.05 was considered significant. Results: The prevalence of OSA in RIAS was five times higher in patients with non-aneurysm group, p=0.002. The number of patients with hypertension (p=0.0001), BMI greater than 30 (p=0.0001), hyperlipidemia (p=0.018), chronic heart disease (CHD, p=0.002) or prior ischemic stroke (p=0.001) was significantly higher in the OSA group. Similarly, the number of wide neck aneurysms (p=0.0001) and aneurysm with greater than 7mm (p=0.004), poor Hunt and Hess grade IV-V (p=0.005), vasospasms, (p=0.03), patients with poor modified Rankin scale (mRS) scores (3–6) was significantly higher in the OSA group (p=0.0001). Interestingly, for the first time both in univariate (p=0.01) and multivariate (p=0.003) regression analysis, OSA was identified as an individual predictor of unfavorable outcome. In addition, hypertension (p=0.04), smoking (p=0.049), chronic heart disease (p=0.01), Hunt and Hess grade IV-V (p=0.04), were revealed as positive predictors of poor outcome of RIAs. Conclusion: This is a pioneer study to determine the association between OSA and ruptured cerebral aneurysm in terms of comorbidities, size of aneurysm, severity of symptoms and outcomes after treatment. The severity of disease and overall outcome (mRS) of RIAs are affected by the concurrence of OSA. In addition, for the first time, OSA is identified as a positive predictor of unfavorable outcome of RIAs. Therefore, screening for OSA as well as prevention and or treatment of OSA would be beneficial for these patients with RIAs. Support (If Any): None.