Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience
Abstract Background Early treatment for patients with aneurysmal subarachnoid hemorrhage (aSAH) could significantly reduce the risk of re-bleeding and improve clinical outcomes. We assessed the different time intervals from the initial hemorrhage, admission, and endovascular treatment and identified...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | Chinese Neurosurgical Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41016-021-00262-0 |
| _version_ | 1818730633746186240 |
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| author | Xiaoxi Zhang Haishuang Tang Qiao Zuo Gaici Xue Guoli Duan Yi Xu Bo Hong Rui Zhao Pengfei Yang Jianmin Liu Qinghai Huang |
| author_facet | Xiaoxi Zhang Haishuang Tang Qiao Zuo Gaici Xue Guoli Duan Yi Xu Bo Hong Rui Zhao Pengfei Yang Jianmin Liu Qinghai Huang |
| author_sort | Xiaoxi Zhang |
| collection | DOAJ |
| description | Abstract Background Early treatment for patients with aneurysmal subarachnoid hemorrhage (aSAH) could significantly reduce the risk of re-bleeding and improve clinical outcomes. We assessed the different time intervals from the initial hemorrhage, admission, and endovascular treatment and identified the risk factors contributing to delay. Methods Between February 2017 and December 2019, 422 consecutive aSAH patients treated in a high-volume hospital were collected and reviewed. Risk factors contributing to admission delay and treatment delay were analyzed with univariate and multivariate analysis. Results One hundred twenty-two (28.9%) were admitted to the high-volume hospital at the day of symptom onset and 386 (91.5%) were treated with endovascular management at the same day of admission. The multivariate analysis found that younger age (P = 0.022, OR = 0.981, 95% CI 0.964–0.997) and good Fisher score (P = 0.002, OR = 0.420, 95% CI 0.245–0.721) were independent risk factors of admission delay. None was found to be related with treatment delay. Multivariate analysis (OR (95% CI)) showed that higher age 1.027 (1.004–1.050), poorer Fisher score 3.496 (1.993–6.135), larger aneurysmal size 1.112 (1.017–1.216), and shorter interval between onset to admission 1.845 (1.018–3.344) were independent risk factors of poorer clinical outcome. Conclusion Treatment delay was mainly caused by pre-hospital delay including delayed admission and delayed transfer. Our experience showed that cerebrovascular team could provide early treatment for aSAH patients. Younger age and good Fisher score were significantly related with admission delay. However, admission delay was further significantly correlated with better clinical outcome. |
| first_indexed | 2024-12-17T23:04:53Z |
| format | Article |
| id | doaj.art-cffa8b19d2b743eaaac24edd45179851 |
| institution | Directory Open Access Journal |
| issn | 2057-4967 |
| language | English |
| last_indexed | 2024-12-17T23:04:53Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Chinese Neurosurgical Journal |
| spelling | doaj.art-cffa8b19d2b743eaaac24edd451798512022-12-21T21:29:18ZengBMCChinese Neurosurgical Journal2057-49672021-10-01711710.1186/s41016-021-00262-0Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experienceXiaoxi Zhang0Haishuang Tang1Qiao Zuo2Gaici Xue3Guoli Duan4Yi Xu5Bo Hong6Rui Zhao7Pengfei Yang8Jianmin Liu9Qinghai Huang10Department of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityDepartment of Neurosurgery, Changhai Hospital, Naval Military Medical UniversityAbstract Background Early treatment for patients with aneurysmal subarachnoid hemorrhage (aSAH) could significantly reduce the risk of re-bleeding and improve clinical outcomes. We assessed the different time intervals from the initial hemorrhage, admission, and endovascular treatment and identified the risk factors contributing to delay. Methods Between February 2017 and December 2019, 422 consecutive aSAH patients treated in a high-volume hospital were collected and reviewed. Risk factors contributing to admission delay and treatment delay were analyzed with univariate and multivariate analysis. Results One hundred twenty-two (28.9%) were admitted to the high-volume hospital at the day of symptom onset and 386 (91.5%) were treated with endovascular management at the same day of admission. The multivariate analysis found that younger age (P = 0.022, OR = 0.981, 95% CI 0.964–0.997) and good Fisher score (P = 0.002, OR = 0.420, 95% CI 0.245–0.721) were independent risk factors of admission delay. None was found to be related with treatment delay. Multivariate analysis (OR (95% CI)) showed that higher age 1.027 (1.004–1.050), poorer Fisher score 3.496 (1.993–6.135), larger aneurysmal size 1.112 (1.017–1.216), and shorter interval between onset to admission 1.845 (1.018–3.344) were independent risk factors of poorer clinical outcome. Conclusion Treatment delay was mainly caused by pre-hospital delay including delayed admission and delayed transfer. Our experience showed that cerebrovascular team could provide early treatment for aSAH patients. Younger age and good Fisher score were significantly related with admission delay. However, admission delay was further significantly correlated with better clinical outcome.https://doi.org/10.1186/s41016-021-00262-0Intracranial aneurysm, RuptureCoiling with stent placementProcedure-related complicationSafety |
| spellingShingle | Xiaoxi Zhang Haishuang Tang Qiao Zuo Gaici Xue Guoli Duan Yi Xu Bo Hong Rui Zhao Pengfei Yang Jianmin Liu Qinghai Huang Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience Chinese Neurosurgical Journal Intracranial aneurysm, Rupture Coiling with stent placement Procedure-related complication Safety |
| title | Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience |
| title_full | Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience |
| title_fullStr | Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience |
| title_full_unstemmed | Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience |
| title_short | Treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment: a high-volume hospital experience |
| title_sort | treatment delay from aneurysmal subarachnoid hemorrhage to endovascular treatment a high volume hospital experience |
| topic | Intracranial aneurysm, Rupture Coiling with stent placement Procedure-related complication Safety |
| url | https://doi.org/10.1186/s41016-021-00262-0 |
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