The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage

Orakdöğen, Metin; Akinci, Ahmet Tolgay; SIMSEK, OSMAN; TUTUNCULER, BANU; AKTURK, YENER

doi:10.14744/tjtes.2020.49196

The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage

Ahmet Tolgay Akıncı, (Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne-Turkey)

Yener Aktürk, (Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne-Turkey)

Banu Tütüncüler, (Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne-Turkey)

Metin Orakdöğen, (Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne-Turkey)

Osman Şimşek (Department of Neurosurgery, Trakya University Faculty of Medicine, Edirne-Turkey)

Ulusal Travma ve Acil Cerrahi Dergisi

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Yıl: 2021 Cilt: 27 Sayı: 4 Sayfa Aralığı: 449 - 456 Metin Dili: İngilizce DOI: 10.14744/tjtes.2020.49196 İndeks Tarihi: 18-05-2022

The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage

Öz:

BACKGROUND: The optimal timing of intervention for aneurysmatic subarachnoid hemorrhage is one of the historically controversial issues in neurosurgery. Although numerous studies investigated the subject, they had many limitations due to the nature of the disease. Early and ultra-early interventions have gained more and more supporters in recent decades. Nevertheless, the effects of the early and ultra-early intervention on the outcome of the disease are far from clarity. METHODS: A single-center retrospective cohort study was carried out at Trakya University Medical Faculty Training and Practice Hospital. The study includes data on all patients admitted with an aneurysmal subarachnoid hemorrhage between January 1, 2001, and December 31. Patients were divided into two groups according to their WFNS grade status: Good (I–III) or poor (IV–V) grades. Patients are also classified according to their Glasgow Outcome Scale score: Unfavorable (1–2) or favorable (3–5) outcomes. Data were analyzed statistically, and the effects of the early and ultra-early intervention on the outcome were assessed. RESULTS: A total of 580 patients were admitted in the study period. Among them, 494 were eligible for the study. The median age (interquartile range) was 55 (18) years. While 244 (49.4%) patients were women, 250 (50.6%) patients were men. Three hundred and fourteen (63.6%) patients were operated, and 25 patients (5.1%) were undergone endovascular treatment. The ultra-early intervention was achieved in 60 (12.1%) patients and 142 patients (28.7%, including the previous ultra-early intervention group) early intervention was achieved. A meaningful outcome difference was present between the poor-grade ultra-early treatment group and the rest (p=0.007). Analogously, a meaningful outcome difference was present between the poor-grade early treatment group and the rest (p<0.001). CONCLUSION: This study supports the growing trend toward early or ultra-early intervention in aneurysmatic subarachnoid hemorrhage. Our findings showed that both early and ultra-early interventions have positive effects on the outcome in poor-grade aneurysmatic subarachnoid hemorrhage patients. Future studies with more homogenized and larger samples should be realized to clarify the optimal timing of intervention for aneurysmatic subarachnoid hemorrhage.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Akinci A, AKTURK Y, TUTUNCULER B, Orakdöğen M, SIMSEK O (2021). The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. , 449 - 456. 10.14744/tjtes.2020.49196
Chicago	Akinci Ahmet Tolgay,AKTURK YENER,TUTUNCULER BANU,Orakdöğen Metin,SIMSEK OSMAN The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. (2021): 449 - 456. 10.14744/tjtes.2020.49196
MLA	Akinci Ahmet Tolgay,AKTURK YENER,TUTUNCULER BANU,Orakdöğen Metin,SIMSEK OSMAN The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. , 2021, ss.449 - 456. 10.14744/tjtes.2020.49196
AMA	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. . 2021; 449 - 456. 10.14744/tjtes.2020.49196
Vancouver	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. . 2021; 449 - 456. 10.14744/tjtes.2020.49196
IEEE	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O "The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage." , ss.449 - 456, 2021. 10.14744/tjtes.2020.49196
ISNAD	Akinci, Ahmet Tolgay vd. "The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage". (2021), 449-456. https://doi.org/10.14744/tjtes.2020.49196

APA	Akinci A, AKTURK Y, TUTUNCULER B, Orakdöğen M, SIMSEK O (2021). The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. Ulusal Travma ve Acil Cerrahi Dergisi, 27(4), 449 - 456. 10.14744/tjtes.2020.49196
Chicago	Akinci Ahmet Tolgay,AKTURK YENER,TUTUNCULER BANU,Orakdöğen Metin,SIMSEK OSMAN The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. Ulusal Travma ve Acil Cerrahi Dergisi 27, no.4 (2021): 449 - 456. 10.14744/tjtes.2020.49196
MLA	Akinci Ahmet Tolgay,AKTURK YENER,TUTUNCULER BANU,Orakdöğen Metin,SIMSEK OSMAN The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. Ulusal Travma ve Acil Cerrahi Dergisi, vol.27, no.4, 2021, ss.449 - 456. 10.14744/tjtes.2020.49196
AMA	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. Ulusal Travma ve Acil Cerrahi Dergisi. 2021; 27(4): 449 - 456. 10.14744/tjtes.2020.49196
Vancouver	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage. Ulusal Travma ve Acil Cerrahi Dergisi. 2021; 27(4): 449 - 456. 10.14744/tjtes.2020.49196
IEEE	Akinci A,AKTURK Y,TUTUNCULER B,Orakdöğen M,SIMSEK O "The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage." Ulusal Travma ve Acil Cerrahi Dergisi, 27, ss.449 - 456, 2021. 10.14744/tjtes.2020.49196
ISNAD	Akinci, Ahmet Tolgay vd. "The effects of the early and ultra-early intervention on the outcome in aneurysmatic subarachnoid hemorrhage". Ulusal Travma ve Acil Cerrahi Dergisi 27/4 (2021), 449-456. https://doi.org/10.14744/tjtes.2020.49196