Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Variation in Patient Characteristics and Outcomes Between Early and Delayed Surgery in Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
First author：Bing Zhao
Corresponding author：Ming Zhong, Shuo Wang
essential_information
2016-02-01
Published articles
Journal：Neurosurgery
Publication type: Research Article
IF(IF): 4.654
PMID: 26421588 Link To Pubmed Full text Download
Background And Purpose
Method
There is no consensus regarding the optimal timing for surgery for poor-grade aneurysmal subarachnoid hemorrhage.
Conclusion
Of the 118 patients included in the study, 80 (68%) underwent early surgery and 38 (32%) underwent delayed surgery. Patients with brain herniation (P < .001) and a lower Fisher grade (P = .02) more often underwent early surgery. Patients in the early group more often underwent decompressive craniectomy (P < .001). Postoperative complications and length of hospital stay did not differ, and outcomes were similar between the 2 groups. Forty (34%) patients had an excellent outcome (modified Rankin score 0-1). Multivariate analysis showed a slight trend toward an excellent outcome in the early surgery group. Younger age, World Federation of Neurosurgical Societies grade IV after resuscitation, and middle cerebral artery aneurysms were independent predictors of an excellent outcome.
Main results
Poor-grade aneurysmal subarachnoid hemorrhage was defined as a World Federation of Neurosurgical Societies grade of IV or V after resuscitation. Early surgery was defined as surgery performed within 72 hours of ictus, and delayed surgery was defined as surgery after 72 hours. Outcomes were assessed by modified Rankin score. The mean time of follow-up was 12.5 ± 3.4 months.