[en] Objectives • To determine the prognosis of patients admitted by spontaneous subarachnoid haemorrhage (SAH) and associated factors. • To develop predictive models at admission of in-hospital mortality and at long-term survival in these patients. Material and methods Retrospective follow-up study of patients admitted in 2003-2013 to the Intensive Care Unit of the Complexo Hospitalario Universitario de A Coruña with SAH. We analyzed on demographic characteristics, comorbidity, clinical debut, prognostic seores at admission, diagnostic-therapeutic management, complications, inhospital mortality and survival at 10 years after diagnosis. Results We included 536 patients (Age: 56.9±14.1 years, 59.3% women, Charlson index 0.7±1.1), the most frequent manifestations being headache (76.5%), dizziness (54.1 %) and coma (34.0%). The presence of aneurysms (SAH-A) was found in 78.1 % of cases, idiopathic etiologic (SAH-I) was found in 17.9%, and 3.2% presented perimesencephalic bleeding (SAH-PM). Neurological complications occurred in 53.7% of cases during admission and 48.9% of cases presented systemic complication, which were more frequent in SAHA. In-hospital mortality was 27.8% and probability of survival since admission was 62.8% at 5 years and 59,1 % at 10 years. The predictive variables ofin-hospital mortalitywere debut coma (OR=l.87), a score of 3-4 on the Fisher scale (OR=2.26), the APACHE II scale in the first 24 hours (OR=l.05) and total SOFA day O (OR=l.19), the same variables together with age, being associated with long-term survival. Two predictive models of in-hospital mortality and survival were constructed, with adequate calibration and discriminating capacity. 37 Resumen del estudio Conclusions Patients with SAH are young, with low comorbidity and significant prognostic impact depending on the clinic of debut, severity on admission and complications during the stay. Depending on the subtype, patients have different characteristics and prognosis. The proposed prediction models improve the predictive capacity of other published scales.

[gl] Obxectivos • Determinar o prognóstico de doentes ingresados por unha hemorraxia subaracnoidea espontánea (HSA) e factores asociados. • Desenrolar modelos preditivos ao ingreso de mortalidade intrahospitalaria e supervivencia a longo prazo nestes doentes. Material e métodos Estudo de seguimento retrospectivo dos doentes ingresados en 2003-2013 na Unidade de Coidados Intensivos do Complexo Hospitalario Universitario da Coruña con HSA. Analizáronse características demográficas, comorbilidade, clínica de debut, escalas pronósticas ao ingreso, manexo diagnósticoterapéutico, complicacións, mortalidade intrahospitalaria e supervivencia aos 10 anos tras o diagnóstico. Resultados Incluíronse 536 doentes (Idade: 56,9±14,1 anos, 59,3% mulleres, índice de Charlson 0,7±1,1), senda as manifestacións máis frecuentes cefalea (76,5%), mareo (54,1%) e coma (34,0%). No 78,1% de casos constatouse presenza de aneurisma (HSA-A), nun 17,9% non se atopou causa (HSA-I), o 3,2% presentou sangrado perimesencefálico (HSA-PM). Un 53,7% presentaron complicacións neurolóxicas durante o seu ingreso e un 48,9% algunha complicación sistémica, máis frecuentes na HSA-A. A mortalidade intrahospitalaria foi do 27,8%, e a probabilidade global de supervivencia desde o ingreso foi do 62,8% aos 5 anos o do 59, 1 % aos 10 anos. As variables predictoras de mortalidade intrahospitalaria foron o coma de debut (OR=l,87), unha puntuación 3-4 na escala de Fisher (OR=2,26), a escala APACHE II nas primeiras 24 horas (OR=l,05) e o SOFA total día O (OR=l,19), asociándose as mesmas variables, xunto coa idade, á supervivencia a longo prazo. Construíronse dous modelos predictivos de mortalidade intrahospitalaria e supervivencia, con axeitada calibración e capacidade discriminativa. Conclusións Os doentes con HSA son novas, con escasa comorbilidade e importante impacto pronóstico dependente da clínica de debut, gravidade ao ingreso e complicaciones durante a estancia. En función do subtipo os doentes presentan características e prognóstico diferenciado. Os modelos predictivos propostos mellaran a capacidade pronóstica doutras escalas publicadas.