Evidence map›Paper›PMID 37610642›Full record

ArticleNeurocritical care2024

Clinical Outcome of Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage with Bundled Treatments: A Propensity Score-Matched Analysis.

Young Hoon Choi, Eun Jin Ha, Youngbo Shim, Jungook Kim, Yoon-Hee Choo, Hye Seon Kim, Sung Ho Lee, Kang Min Kim, Won-Sang Cho, Hyun-Seung Kang and 1 more

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Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Young Hoon ChoiDepartment of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
Eun Jin HaDepartment of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea. 65932@snuh.org.ORCID 0000-0003-3278-0550
Youngbo ShimDepartment of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea.
Jungook KimDepartment of Critical Care Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea.
Yoon-Hee ChooDepartment of Neurosurgery, Seoul St. Mary's Hospital and College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Hye Seon KimDepartment of Neurosurgery, Incheon St. Mary's Hospital and College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea.
Sung Ho LeeDepartment of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Kang Min KimDepartment of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Won-Sang ChoDepartment of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Hyun-Seung KangDepartment of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Jeoug Eun KimDepartment of Neurosurgery, College of Medicine, Seoul National University, Seoul, Republic of Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoor-grade aneurysmal subarachnoid hemorrhage (aSAH), defined as Hunt and Hess (HH) grades IV and V, is a challenging disease because of its high mortality and poor functional outcomes. The effectiveness of bundled treatments has been demonstrated in critical diseases. Therefore, poor-grade aSAH bundled treatments have been established. This study aims to evaluate whether bundled treatments can improve long-term outcomes and mortality in patients with poor-grade aSAH.

methodsThis is a comparative study using historical control from 2008 to 2022. Bundled treatments were introduced in 2017. We compared the rate of favorable outcomes (modified Rankin Scale score 0-2) at 6 months and mortality before and after the introduction of the bundled treatments. To eliminate confounding bias, the propensity score matching method was used.

resultsA total of 90 consecutive patients were evaluated. Forty-three patients received bundled treatments, and 47 patients received conventional care. The proportion of patients with HH grade V was higher in the bundle treatment group (41.9% vs. 27.7%). Conversely, the proportion of patients with fixed pupils on the initial examination was higher in the conventional group (30.2% vs. 38.3%). After 1:1 propensity score matching, 31 pairs were allocated to each group. The proportion of patients with 6-month favorable functional outcomes was significantly higher in the bundled treatments group (46.4% vs. 20.7%, p = 0.04). The 6-month mortality rate was 14.3% in the bundled treatments group and 27.3% in the conventional group (p = 0.01). Bundled treatments (odd ratio 14.6 [95% confidence interval 2.1-100.0], p < 0.01) and the presence of an initial pupil reflex (odd ratio 12.0 [95% confidence interval 1.4-104.6], p = 0.02) were significantly associated with a 6-month favorable functional outcome.

conclusionsThe bundled treatments improve 6-month functional outcome and mortality in patients with poor-grade aSAH.

Indexed as

Subarachnoid HemorrhageHumansPropensity ScoreTreatment OutcomeAneurysmal subarachnoid hemorrhageCritical care outcomesIntensive care unitsNeurosurgeryPatient care bundle

Identifiers

PMID37610642

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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.