Observational studyBMJ open2015
Factors and outcomes associated with ultra-early surgery for poor-grade aneurysmal subarachnoid haemorrhage: a multicentre retrospective analysis.
Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Timing of aneurysm repair and clinical outcomes after aneurysmal subarachnoid hemorrhage: a systematic review.Journal of neurology · 2026Pooled it
- Early predictors of functional outcome in poor-grade aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.BMC neurology · 2022Pooled it
- Volume of Aneurysmal Subarachnoid Hemorrhage and Cognitive Outcomes.Neurocritical care · 2026Observational
- Etiology-specific optimal timing of surgical intervention for intracranial hemorrhage: a systematic review and network meta-analysis.International journal of surgery (London, England) · 2025Article
- A comparative analysis of outcomes in patients with aneurysmal subarachnoid hemorrhage based on surgical timing.Frontiers in surgery · 2025Article
- Article
- Length of Survival, Outcome, and Potential Predictors in Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients Treated with Microsurgical Clipping.CNS & neurological disorders drug targets · 2024Article
- Outcomes following poor-grade aneurysmal subarachnoid haemorrhage: a prospective observational study.Acta neurochirurgica · 2023Observational
- Rs12976445 polymorphism is associated with the risk of post-SAH re-bleeding by modulating the expression of microRNA-125 and ET-1.Scientific reports · 2022Article
- Association of Onset-to-Treatment Time With Discharge Destination, Mortality, and Complications Among Patients With Aneurysmal Subarachnoid Hemorrhage.JAMA network open · 2022Article
- A Nomogram for Predicting the Need of Postoperative Tracheostomy in Patients With Aneurysmal Subarachnoid Hemorrhage.Frontiers in neurology · 2021Article
- The Factors Associated with Outcomes in Surgically Managed Ruptured Cerebral Aneurysm.The Malaysian journal of medical sciences : MJMS · 2018Article
- Keyhole Approach Combined With External Ventricular Drainage for Ruptured, Poor-Grade, Anterior Circulation Cerebral Aneurysms.Medicine · 2015Observational
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine factors and outcomes associated with ultra-early surgery for poor-grade aneurysmal subarachnoid haemorrhage (aSAH).
designA multicentre retrospective analysis, observational study.
settingHigh-volume teaching hospitals (more than 150 aSAH cases per year).
participants118 patients with World Federation of Neurosurgical Societies (WFNS) grades IV and V underwent surgical treatment. Ultra-early surgery was defined as surgery performed within 24 h of aSAH, and delayed surgery as surgery performed after 24 h. Outcome was assessed by modified Rankin Scale (mRS). The mean time of follow-up was 12.5±3.4 months (range 6-28 months).
results47 (40%) patients underwent ultra-early surgery, and 71 (60%) patients underwent delayed surgery. Patients with WFNS grade V (p=0.011) and brain herniation (p=0.004) more often underwent ultra-early surgery. Postoperative complications were similar in ultra-early and delayed surgery groups. Adjusted multivariate analysis showed the outcomes were similar between the two groups. Multivariate analysis of predictors of poor outcome, ultraearly surgery was not an independent predictor of poor outcome, while advanced age, postresuscitation WFNS V grade, intraventricular haemorrhage, brain herniation and non-middle cerebral artery (MCA) aneurysms were associated with poor outcome.
conclusionsAlthough patients with WFNS grade V and brain herniation more often undergo ultra-early surgery, postoperative complications and outcomes in selected patients were similar in the two groups. Patients of younger age, WFNS grade IV, absence of intraventricular haemorrhage, absence of brain herniation and MCA aneurysms are more likely to have a good outcome. Ultra-early surgery could improve outcomes in carefully selected patients with poor-grade aSAH.
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