title: Tendencies in cerebral aneurism treatment: Analysis of a hospital series.
abstract: OBJECTIVE
  To discover if there have been changes in the treatment time for SAH in our hospital environment.
  
  
  METHODS
  Comparative analysis of 571 patients treated at Hospital Universitari la Fe during 2 different time periods. The SAH-OLD group consisted of 462 patients attended consecutively between April 1997 and March 2005, while SAH-NEW comprised 109 patients attended consecutively between March 2007 and April 2010. We analysed demographic factors, risk factors, severity at time of admission, time to arteriography, diagnosis of aneurysm, use of surgical or endovascular treatment and time to treatment, frequency of neurological complications, in-hospital deaths, and modified Rankin Scale (mRS) at discharge.
  
  
  RESULTS
  Mean time to arteriography was 2.18 ± 2.5 days for the SAH-OLD group and 2.37 ± 2.23 days, for the SAH-NEW group (P=.49). Mortality rates for SAH-OLD patients were calculated at 30%, compared to 18.3% in SAH-NEW patients (P=.01). Among patients surviving the hospital stay in the SAH-OLD group, 13.3% had an mRS > 3, compared to 21.3% of survivors in the SAH-NEW group (P=.06). Two hundred forty-five patients in the SAH-OLD group had cerebral aneurysms and 208 were treated (45% of the patient total). Sixty-five of the SAH-NEW patients received treatment (60% of the patient total, P=.007). In the SAH-OLD group, 62.9% of the patients underwent embolisation vs 74.6% in the SAH-NEW group (P=.08). Time to embolisation was 4.7 ± 8.2 days for SAH-OLD patients and 2.12 ± 2.2 days for SAH-NEW patients (P=.01). Twenty-two percent of SAH-OLD patients underwent surgery, compared to 25.4% in the SAH-NEW group (P=.62).
  
  
  CONCLUSIONS
  Care for SAH patients has improved in this hospital: results include fewer mortalities, a higher number of treatments with a smaller proportion of endovascular treatments, and shorter times to treatment. Elapsed time to arteriography remains stable.
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España. Electronic address: aida.lago@sen.es.
authors.forename: A
authors.initials: A
authors.lastname: Lago
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
authors.forename: R
authors.initials: R
authors.lastname: López-Cuevas
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
authors.forename: J I
authors.initials: JI
authors.lastname: Tembl
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
authors.forename: G
authors.initials: G
authors.lastname: Fortea
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
authors.forename: D
authors.initials: D
authors.lastname: Górriz
authors.affiliation: Sevicio de Radiología, Hospital Universitario La Fe, Valencia, España.
authors.forename: F
authors.initials: F
authors.lastname: Aparici
authors.affiliation: Servicio de Neurología, Hospital Universitario La Fe, Valencia, España.
authors.forename: V
authors.initials: V
authors.lastname: Parkhutik
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured; D004621:Embolization, Therapeutic; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage; D016896:Treatment Outcome
keywords: Endovascular treatment; Epidemiology; Epidemiología; Hemorragia subaracnoidea; Mortalidad; Mortality; Prognosis; Pronóstico; Subarachnoid haemorrhage; Surgical treatment; Tratamiento intravascular; Tratamiento quirúrgico