Evidence map›Paper›PMID 27651379›Full record

SynthesisNeurocritical care2016

Functional Outcome After Poor-Grade Subarachnoid Hemorrhage: A Single-Center Study and Systematic Literature Review.

Airton Leonardo de Oliveira Manoel, Ann Mansur, Gisele Sampaio Silva, Menno R Germans, Blessing N R Jaja, Ekaterina Kouzmina, Thomas R Marotta, Simon Abrahamson, Tom A Schweizer, Julian Spears and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurocritical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  13. Utility of predictive scales for emergency department patients with a new diagnosis of aneurysmal subarachnoid hemorrhage.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Airton Leonardo de Oliveira ManoelDepartment of Medical Imaging, Interventional Neuroradiology, St. Michael's Hospital, University of Toronto, 3-141 CC, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. airtonleo.manoel@gmail.com.ORCID 0000-0002-9593-1013
Ann MansurNeuroscience Research Program, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.
Gisele Sampaio SilvaNeurology and Neurosurgery Department, Universidade Federal de São Paulo, São Paulo, Brazil.
Menno R GermansDepartment of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Blessing N R JajaNeuroscience Research Program, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.
Ekaterina KouzminaDepartment of Medical Imaging, Interventional Neuroradiology, St. Michael's Hospital, University of Toronto, 3-141 CC, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Thomas R MarottaDepartment of Medical Imaging, Interventional Neuroradiology, St. Michael's Hospital, University of Toronto, 3-141 CC, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
Simon AbrahamsonDepartment of Critical Care Medicine, Trauma and Neurosurgical Intensive Care Unit, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
Tom A SchweizerNeuroscience Research Program, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.
Julian SpearsNeuroscience Research Program, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.
R Loch MacdonaldNeuroscience Research Program, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposePoor-grade subarachnoid hemorrhage (SAH) (World Federation of Neurosurgical Societies grade 4 and 5) is associated with high mortality rates and unfavorable functional outcomes. We report a single-center cohort of poor-grade SAH patients, combined with a systematic review of studies reporting functional outcome in the poor-grade SAH population.

methodsData on a cohort of poor-grade SAH patients treated between 2009 and 2013 were retrospectively collected and combined with a systematic review (from inception to November 2015; PubMed, Embase). Two reviewers assessed the studies independently based on predefined inclusion criteria: consecutive poor-grade SAH, functional outcome measured at least 3 months after hemorrhage, and the report of patients who died before aneurysm treatment.

resultsThe search yielded 329 publications, and 23 met our inclusion criteria with 2713 subjects enrolled from 1977 to 2014 in 10 countries (including 179 poor-grade patients from our cohort). Mortality rate was 60 % (1683 patients), of which 806 (29 %) died before and 877 (31 %) died after aneurysm treatment, respectively. Treatment was undertaken in 1775 patients (1775/2826-63 %): 1347 by surgical clipping (1347/1775-76 %) and 428 (428/1775-24 %) by endovascular methods. Outcome was favorable in 794 patients (28 %) and unfavorable in 1867 (66 %). When the studies were grouped into decades, favorable outcome increased from 13 % in the late 1970s to early 1980s to 35 % in the late 1980s to early 1990s, and remained unchanged thereafter.

conclusionAlthough mortality remains high in poor-grade SAH patients, a favorable functional outcome can be achieved in approximately one-third of patients. The development of new diagnostic methods and implementation of therapeutic approaches were probably responsible for the decrease in mortality and improvement in the functional outcome from 1970 to the 1990s. The plateau in functional outcome seen thereafter might be explained by the treatment of sicker and older patients and by the lack of new therapeutic interventions specific for SAH.

Indexed as

Outcome Assessment, Health CareSeverity of Illness IndexAdultAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesSubarachnoid HemorrhageMortalityPrognosisSubarachnoid hemorrhageSystematic review

Identifiers

PMID27651379

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.