The key to improving prognosis for aneurysmal subarachnoid hemorrhage remains in the pre-hospitalization period

Surgical Neurology
Takeshi MiyazakiTakato Kagawa

Abstract

Despite advances in neurosurgical management, aneurismal subarachnoid hemorrhage (aSAH) still has high mortality and morbidity. This study aimed to clarify how delaying hospital admission after aSAH contributes to worse prognosis even today and to find the possibility for an improvement of its prognosis by early admission. Four hundred twenty-one consecutive patients are the basis for this study. Cause of delay was classified into 5 categories: patient delay (PD), doctor delay (DD), transportation delay (TD), no delay (ND) (within 2 hours of onset), and others. Condition of each patient was assessed at time of onset and admission using H&K. The relationships between cause of delay and worsening of Hunt and Kosnik grading (H&K) were examined. The median delay time was 1.7 days. Only 41% of patients visited our institution without delay. Admission delay, especially PD and DD, exhibited a significant correlation to worsening of H&K. In addition to nondirect admission, misdiagnosis or delayed diagnosis contributed significantly to worsening of H&K. Incidence of DD has declined in recent years, whereas that of PD has increased. Consequently, no change in total number of delays was found. There remains much room for an improvement of...Continue Reading

References

Apr 1, 1985·Journal of Neurosurgery·B LjunggrenS Zygmunt
Jul 1, 1985·Stroke; a Journal of Cerebral Circulation·N F KassellH Mazuz
Apr 1, 1981·Journal of Neurosurgery·B LjunggrenG Sundbärg
Jan 1, 1995·Acta neurochirurgica·R DerutyL Bognar
Sep 1, 1996·Stroke; a Journal of Cerebral Circulation·P L MayerL N Hopkins
Jul 29, 1999·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·G H PorteousW S Smith
Jan 6, 2000·The New England Journal of Medicine·J A Edlow, L R Caplan
Jun 24, 2000·JAMA : the Journal of the American Medical Association·M J AlbertsM D Walker
Sep 6, 2001·Stroke; a Journal of Cerebral Circulation·H OhkumaS Suzuki
Mar 22, 2003·Stroke; a Journal of Cerebral Circulation·René HandschuFrank Erbguth
Sep 27, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·T SakakiA Fukuzumi

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Citations

Apr 26, 2012·Expert Opinion on Investigational Drugs·Christine BarryRobert Vink
Dec 25, 2007·The Journal of Emergency Medicine·Jonathan A EdlowChristopher S Ogilvy
Oct 1, 2013·Progress in Neurobiology·Sheng ChenJohn H Zhang
Oct 4, 2016·Journal of Neurosciences in Rural Practice·Linda Jayne NicholsChristine Stirling
Feb 27, 2007·Stroke; a Journal of Cerebral Circulation·Marian J Vermeulen, Michael J Schull
Feb 27, 2007·Stroke; a Journal of Cerebral Circulation·Jonathan A Edlow
Feb 4, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Thuy Phuong NguyenSeana Gall

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