OBJECTIVE: Management of aneurysmal subarachnoid hemorrhage (aSAH) has evolved over the past 2 decades, including refinement of neurosurgical techniques, availability of endovascular options, and evolution of neurocritical care; their impact on SAH outcomes is unclear. DESIGN/ METHODS: Prospectively collected data of patients with aSAH admitted to Johns Hopkins Medical Institutions between 1991 and 2009 were analyzed. We compared survival to discharge and functional outcomes at initial clinic appointment postdischarge (30-120 days) in patients admitted between 1991 and 2000 (phase 1 [P1]) and 2000 and 2009 (phase 2 [P2]), respectively, using dichotomized Glasgow Outcome Scale (good outcome: Glasgow Outcome Scale 4-5). RESULTS: A total of 1134 consecutive patients with aSAH were included in the analysis (P1 46.4%, P2 53.6%). There were higher rates of poor grade Hunt and Hess (P1 23%, P2 28%; P < .05), admission Glasgow Coma Scale score lower than 8 (P1 14%, P2 21%; P < .005), known medical comorbidites (P1 54%, P2 64%; P = .005), associated intraventricular hemorrhage (P1 47%, P2 55%; P < .05), and older population (P1 51.5%, P2 53.5%; P < .05) in P2. Good outcomes were more common in P2 (71.5%) compared with P1 (65.2%), with 2-fold adjusted odds of good outcomes after correction for various confounding factors (P < .001). CONCLUSIONS: Our institutional experience over 2 decades confirms that patients with aSAH have shown significant outcome improvements over time.
OBJECTIVE: Management of aneurysmal subarachnoid hemorrhage (aSAH) has evolved over the past 2 decades, including refinement of neurosurgical techniques, availability of endovascular options, and evolution of neurocritical care; their impact on SAH outcomes is unclear. DESIGN/ METHODS: Prospectively collected data of patients with aSAH admitted to Johns Hopkins Medical Institutions between 1991 and 2009 were analyzed. We compared survival to discharge and functional outcomes at initial clinic appointment postdischarge (30-120 days) in patients admitted between 1991 and 2000 (phase 1 [P1]) and 2000 and 2009 (phase 2 [P2]), respectively, using dichotomized Glasgow Outcome Scale (good outcome: Glasgow Outcome Scale 4-5). RESULTS: A total of 1134 consecutive patients with aSAH were included in the analysis (P1 46.4%, P2 53.6%). There were higher rates of poor grade Hunt and Hess (P1 23%, P2 28%; P < .05), admission Glasgow Coma Scale score lower than 8 (P1 14%, P2 21%; P < .005), known medical comorbidites (P1 54%, P2 64%; P = .005), associated intraventricular hemorrhage (P1 47%, P2 55%; P < .05), and older population (P1 51.5%, P2 53.5%; P < .05) in P2. Good outcomes were more common in P2 (71.5%) compared with P1 (65.2%), with 2-fold adjusted odds of good outcomes after correction for various confounding factors (P < .001). CONCLUSIONS: Our institutional experience over 2 decades confirms that patients with aSAH have shown significant outcome improvements over time.
Authors: Peter B Forgacs; Baxter B Allen; Xian Wu; Linda M Gerber; Srikanth Boddu; Malik Fakhar; Philip E Stieg; Nicholas D Schiff; Halinder S Mangat Journal: Neurocrit Care Date: 2021-10-20 Impact factor: 3.210
Authors: Robert G Kowalski; Tiffany R Chang; J Ricardo Carhuapoma; Rafael J Tamargo; Neeraj S Naval Journal: Neurocrit Care Date: 2013-12 Impact factor: 3.210
Authors: Dannys Rivero Rodríguez; Claudio Scherle Matamoros; Leda Fernández Cúe; Jose Luis Miranda Hernández; Yanelis Pernas Sánchez; Jesús Pérez Nellar Journal: Neurol Res Int Date: 2015-02-05
Authors: Katja E Wartenberg; David Y Hwang; Karl Georg Haeusler; Susanne Muehlschlegel; Oliver W Sakowitz; Dominik Madžar; Hajo M Hamer; Alejandro A Rabinstein; David M Greer; J Claude Hemphill; Juergen Meixensberger; Panayiotis N Varelas Journal: Neurocrit Care Date: 2019-10 Impact factor: 3.210