Melatonin and risk of mortality in subjects with aneurysmal subarachnoid hemorrhage

Suzy H Lin; Colette Galet; Mario Zanaty; Emine Bayman; William K Rogers; David Hasan; Lauren D Allan

doi:10.1016/j.clineuro.2021.106990

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Melatonin and risk of mortality in subjects with aneurysmal subarachnoid hemorrhage

Journal article

Peer reviewed

Melatonin and risk of mortality in subjects with aneurysmal subarachnoid hemorrhage

Suzy H Lin, Colette Galet, Mario Zanaty, Emine Bayman, William K Rogers, David Hasan and Lauren D Allan

Clinical neurology and neurosurgery, Vol.210, pp.106990-106990

11/2021

DOI: 10.1016/j.clineuro.2021.106990

PMID: 34739880

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Abstract

Delayed cerebral ischemia (DCI) is a cause of morbidity associated with aneurysmal subarachnoid hemorrhage (aSAH). Neuroinflammation contributes to the development of DCI. Melatonin is a sleep-promoting hormone known to have cerebral anti-inflammatory properties. We hypothesized that synthetic melatonin (or the selective melatonin receptor agonist ramelteon) incidentally prescribed to improve sleep may lower the incidence of DCI among hospitalized aSAH patients. Subjects with a Hunt and Hess Grade I-III were identified from a data registry involving all aSAH patients admitted to our hospital between January 2015 and September 1, 2018. A cohort of patients who received either melatonin or ramelteon during their hospitalization was compared to a matched cohort that did not receive these drugs. The primary endpoint was incidence of DCI. Secondary outcomes included modified Rankin score (mRS) at discharge, discharge destination, and mortality at 6 weeks from discharge. The two groups were compared using univariate analysis. P < 0.05 was considered significant. There was no significant difference in the incidence of DCI (15.8% vs. 16.9%, p = 1), discharge mRS (mRS 0–3: 51.3% vs. 45.1%, p = 0.59), discharge disposition (Home: 43.6% vs. 44.4, p = 0.47), or mortality (0% vs. 9.2%; p = 0.074) between the melatonin/ramelteon and non-melatonin groups. The use melatonin had no effect on DCI but may improve mortality in aSAH subjects. Prospective studies using a larger cohort are warranted to validate these findings. •Melatonin prescribed to help sleep does not affect DCI incidence in aSAH patients.•Melatonin did not affect modified Rankin score and discharge disposition.•A trend towards reduction of mortality was observed.

Aneurysmal subarachnoid hemorrhage

Melatonin

Mortality

Details

Title: Subtitle: Melatonin and risk of mortality in subjects with aneurysmal subarachnoid hemorrhage
Creators: Suzy H Lin - Department of Surgery, Division of Acute Care Surgery, University of Iowa, Iowa City, IA, United States
Colette Galet - Department of Surgery, Division of Acute Care Surgery, University of Iowa, Iowa City, IA, United States
Mario Zanaty - Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
Emine Bayman - Department of Anesthesia, University of Iowa, Iowa City, IA, United States
William K Rogers - Department of Anesthesia, University of Iowa, Iowa City, IA, United States
David Hasan - Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
Lauren D Allan - Department of Surgery, Division of Acute Care Surgery, University of Iowa, Iowa City, IA, United States
Resource Type: Journal article
Publication Details: Clinical neurology and neurosurgery, Vol.210, pp.106990-106990
DOI: 10.1016/j.clineuro.2021.106990
PMID: 34739880
NLM abbreviation: Clin Neurol Neurosurg
ISSN: 0303-8467
eISSN: 1872-6968
Publisher: Elsevier B.V
Language: English
Date published: 11/2021
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Iowa Neuroscience Institute; Biostatistics; Surgery; Anesthesia; University of Iowa Health Care; Neurosurgery; Otolaryngology
Record Identifier: 9984214851002771

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