April 1, 1999Journal of neurosurgery

Improved survival after aneurysmal subarachnoid hemorrhage: review of management during a 12-year period

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Why the study?

Does the implementation of new management principles in a neurointensive care setting improve survival and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage?

Structured PICO

Does the implementation of new management principles in a neurointensive care setting improve survival and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage?

Population

1206 patients with subarachnoid hemorrhage (SAH) admitted to the neurosurgery department between 1981 and 1992, mean age 52 years, 59% females. An aneurysm presumably causing the SAH was found in 874 (72%).

Intervention

New management principles (affecting referral guidelines, diagnostic and monitoring methods, and pharmacological and surgical treatment in a neurointensive care setting) during Period B (1987-1992)

Comparator

Previous management principles during Period A (1981-1986)

Outcome

30-day mortality rate, 6-month mortality rate, and clinical outcome evaluated according to the Glasgow Outcome Scale at 2 to 9 years follow-uphard clinical

Implementation of new management principles in a neurointensive care setting significantly reduced mortality and improved long-term clinical outcomes in patients with aneurysmal subarachnoid hemorrhage.

Discussion

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Implication

New neurointensive principles were associated with lower SAH mortality; hypothesis-generating and requires RCT confirmation before practice change.

Cite This Study

Cesarini et al. (1999) studied this question.

synapsesocial.com/papers/6a6fff1fac440176ef28a6b4 https://doi.org/10.3171/jns.1999.90.4.0664

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Implication

New neurointensive principles were associated with lower SAH mortality; hypothesis-generating and requires RCT confirmation before practice change.