1224. Subarachnoid Hemorrhage and Vitamin D Deficiency
Authors: Marcus S. Wong, MD; Jonathan Lee, MD; Vitaly Davidov, BS; Zoulficar Kobeissi, MD (Houston, TX)
Spontaneous or aneurysmal subarachnoid hemorrhage occurs with high morbidity and mortality worldwide. Despite known risk factors, the pathogenesis for subarachnoid hemorrhage is not fully understood. Vitamin D deficiency has been linked to many vascular diseases as it is thought to lead to endothelial dysfunction, perhaps contributing to hypertension, myocardial infarction and cardiovascular disease. There also has been observed a seasonal component to the incidence of subarachnoid hemorrhage, peaking in October and having its nadir in July. There may be a link between sunlight exposure, Vitamin D levels and subarachnoid hemorrhage. Here we investigate the relationship between vitamin D levels and severity of subarachnoid hemorrhage.
A retrospective analysis of patients admitted to a single institution with subarachnoid hemorrhage from January 2013 to 2016 was performed. Those who had a 25-hydroxy vitamin level were analyzed and their Hunt-Hess and Fisher scores compared. Patients were separated into three Vitamin D categories: Low (<10 ng/ml), Deficient (10-29 ng/ml), and Optimal (>30 ng/ml). The Hunt-Hess and Fisher scores of the three groups were separately compared using single factor ANOVA test.
46 patients met criteria. 3 patients were in the Low category, 34 in the Deficient, and 10 in the Optimal. The average Hunt Hess score for low vitamin D was 1.67, 2.76 for deficient, and 2.70 for optimal. They were not significantly different (p=0.248091). The average Fisher score was 2.67 for low vitamin D, 3.06 for deficient, and 3.40 for optimal. These scores were not significantly different (p=0.29927).
This study shows no correlation between serum 25-hydroxy vitamin levels and SAH severity. Some limitations include the power of the study as vitamin D levels in patients are not routinely screened after SAH. Further studies and data collection are ongoing.