title: The effects of timing of aneurysm surgery on vasospasm and mortality in patients with subarachnoid hemorrhage.
abstract: OBJECTIVE
  The purpose of the present study was to compare the effects of early and late surgery on postoperative vasospasm and mortality in patients with subarachnoid hemorrhage (SAH).
  
  
  METHODS
  The data of patients with SAH who underwent aneurysmal clipping at the Kartal Training and Research Hospital between 1999 and 2005 were retrospectively analyzed. The patients who underwent early (0-3 days) and late surgery (> or = 4 days) were evaluated as two groups. Patient outcomes were assessed 1 month after surgery.
  
  
  RESULTS
  Of 159 patients (mean age, 49 years; 71 males) with SAHs, 135 (mean age, 51 years; 55 males) underwent early surgery and 24 patients (mean age, 56 years; 16 males) underwent late surgery. The overall postoperative vasospasm rate was 10.7%. The rate of postoperative vasospasm was significantly higher in the late surgery group (41.7%) compared to the early surgery group (5.2%; p < 0.001). There were 15 post-operative deaths (9.4%). The mortality rate in the late surgery group (25.0%) was significantly higher than the early surgery group (6.7%; p = 0.005).
  
  
  CONCLUSIONS
  The present study has demonstrated that early surgery is advantageous over late surgery in patients with SAH with lower post-operative vasospasm and mortality rates.
authors.affiliation: Dr. Lütfi Kirdar Kartal Research and Training Hospital, First Neurosurgery Clinic, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Dalbayrak
authors.forename: M
authors.initials: M
authors.lastname: Altas
authors.forename: R
authors.initials: R
authors.lastname: Arslan
mesh_terms: D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009493:Neurosurgery / Q000379:methods*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000601:surgery*