Abstract 193: Clinico-radiologic Severity of Subarachnoid Hemorrhage Predicts Coated-platelet Levels and Associated In-hospital Morbidity

Introduction: Coated-platelets (CP), a subpopulation of activated platelets, can be used as a surrogate marker for systemic thrombogenic propensity. Microthrombosis causes delayed cerebral ischemia (DCI) and is a major determinant of morbidity after subarachnoid hemorrhage (SAH). Association studies have reported increased morbidity and mortality after SAH depending on disease severity at admission. Hypothesis: We hypothesized that severe clinical and radiological grades of SAH would be associated with increased CP and contribute to DCI. Methods: Prospective cohort of 44 patients with non-traumatic, spontaneous SAH was enrolled. Clinical and radiological severity was recorded using Hunt and Hess (HH p=0.0251) than in those with grades 1 and 2. Similarly, higher clinical and radiological severity were associated with subsequent downtrending levels of CP after an initial rise but was only statistically significant for SAPS-II (upper tertile 0.8%/day vs middle tertile 1.7% vs lower tertile 1.02%/day, p=0.0297). Conclusion: Higher initial CP levels among patients with severe clinico-radiologic findings, along with declining CP trends over 21 days, suggest that neurohumoral triggers may induce systemic thrombogenicity and contribute to DCI and clinical vasospasm after SAH.