Review of Association between time to emergency neurosurgery and clinical outcomes for spontaneous hemorrhagic stroke: A nationwide observational study — Kim, 2022

Hemorrhagic stroke has a high death rate and significant neurological consequences. This study examined the relationship between time from ED arrival to emergency neurosurgery and clinical outcomes in spontaneous hemorrhagic stroke patients. Using Korea's emergency database, a cross-sectional study was undertaken. Patients with spontaneous hemorrhagic stroke who got neurosurgery within 12 hours after ED visit were recruited. Neurosurgery time was the main exposure, and in-hospital death was the main consequence. Logistic regression was multivariable. 525 (20.2%) patients in the ultra-early (0–2 hours) group, 1,093 (42.0%) in the early (2–4 hours), and 984 (37.8%) in the late (4–12 hours) group underwent surgery. The early group had lower in-hospital mortality than the ultra-early and late groups (p = 0.06). Early group OR (95 percent CI) for in-hospital mortality was 0.78 (0.63–0.96) versus 0.90 (0.69–1.16) for late group. In patients with spontaneous hemorrhagic stroke, early neurosurgery within 2–4 hours of ED arrival improved survival.

Kim KH, Ro YS, Park JH, Jeong J, Shin SD, Moon S (2022) Association between time to emergency neurosurgery and clinical outcomes for spontaneous hemorrhagic stroke: A nationwide observational study. PLoS ONE 17(4): e0267856. https://doi.org/10.1371/journal.pone.0267856