Journal article
The international cooperative study on the timing of aneurysm surgery: The north american experience
Stroke (1970), Vol.23(2), pp.205-214
1992
DOI: 10.1161/01.STR.23.2.205
PMID: 1561649
Abstract
BACKGROUND AND PURPOSE: The timing of aneurysm surgery after subarachnoid hemorrhage is a major neurosurgical controversy addressed by the International Cooperative Study on the Timing of Aneurysm Surgery (1980-1983). The present report examines the results of this trial in the subgroup of patients admitted to North American centers.METHODS: The method of study was a large, multicenter, prospective, epidemiological survey. Neurosurgeons were required to indicate prospectively the interval to planned aneurysm surgery at the time of patient admission. Outcome at 6 months was determined by a blinded evaluator, and overall management results were analyzed by the planned surgical interval.RESULTS: Seven hundred seventy-two (21.9% of the total study population) patients admitted from days 0 to 3 after subarachnoid hemorrhage were accrued in North American centers. Overall outcome in patients planned for surgery in days 0-3 was equivalent in terms of mortality (after adjustment for prognostic variables) to patients planned for days 11-32, but the early patients had significantly improved rates of good recovery (70.9% versus 61.7%, p less than 0.01). Patients planned for surgery during the days 7-10 interval had nearly twice the mortality of patients in the other intervals.CONCLUSIONS: In contrast to the results from the overall trial, which found no difference between early and delayed surgery, results were best in North American centers when surgery was planned between days 0 and 3 after subarachnoid hemorrhage. These findings argue strongly for early diagnosis and referral for surgical intervention of North American patients suspected of having a ruptured cerebral aneurysm.
Details
- Title: Subtitle
- The international cooperative study on the timing of aneurysm surgery: The north american experience
- Creators
- E. Clarke HaleyNeal F KassellJames C Torner
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.23(2), pp.205-214
- DOI
- 10.1161/01.STR.23.2.205
- PMID
- 1561649
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 1992
- Academic Unit
- Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983995024902771
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