ArticleBMJ open2023
National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Global burden of subarachnoid hemorrhage in young adults, 1990-2021: disparities, risk factors, and projections to 2050.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Trends in Incidences, Treatments and Outcomes of Spontaneous Subarachnoid Hemorrhage in Korea Between 2002 and 2022.Journal of Korean medical science · 2025Article
- Inpatient neurosurgical mortality in germany: a comprehensive analysis of 2023 in-hospital data.Neurosurgical review · 2025Article
- Has a fast treatment transition from surgical to endovascular operations improved the survival of aneurysmal subarachnoid hemorrhage?Acta neurochirurgica · 2025Article
- Impact of age on surgical outcomes for world federation of neurosurgical societies grade I and II aneurysmal subarachnoid haemorrhage: a novel prognostic model using recursive partitioning analysis.Neurosurgical review · 2024Article
- Declining trend in the estimated annual rupture rate of unruptured cerebral aneurysms in Japan: a nationwide study.Neurosurgical review · 2024Article
- The Role of Nursing Care in the Management of Patients with Traumatic Subarachnoid Hemorrhage.Galen medical journal · 2023Article
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Authors and funding
40 authors at 20 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
objectivesTo examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.
designRetrospective study.
settingSix hundred and thirty-one primary care institutions in Japan.
participantsForty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database. PRIMARY AND SECONDARY OUTCOME MEASURES: Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3-6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1-25 points).
resultsIn the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.
conclusionsThe 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era.
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