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Referral pattern of patients with aneurysmal subarachnoid hemorrhage
W I Schievink1, D J van der Werf, L M Hageman
1Department of Neurosurgery, University of Amsterdam, The Netherlands.
Insights
Delays in seeking medical care and physician diagnostic errors significantly impact outcomes for patients with aneurysmal subarachnoid hemorrhage (SAH). Prompt diagnosis and intervention are crucial for improving patient survival and recovery after SAH.
Area of Science:
- Neurosurgery
- Neurology
- Public Health
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) is a critical neurological emergency.
- Timely diagnosis and intervention are vital for improving patient outcomes.
Purpose of the Study:
- To analyze the referral patterns of patients with aneurysmal subarachnoid hemorrhage (SAH).
- To identify causes of delay in diagnosis and treatment for SAH patients.
Main Methods:
- Retrospective analysis of 334 patients admitted to a neurosurgical clinic with SAH.
- Examination of referral timelines, patient-reported delays, and physician diagnostic errors.
Main Results:
- 49% of patients were admitted more than 24 hours after SAH onset.
- Patient-related delays occurred in 29 cases; physician diagnostic errors in 95 cases.
- Referring hospitals contributed to delays in 97 patients, with common misdiagnoses including migraine and influenza.
Conclusions:
- Significant delays in care for SAH patients are attributed to both patient factors and physician diagnostic errors.
- Public and physician education on SAH symptoms and the importance of prompt treatment is essential.
- Improving early recognition and management can enhance outcomes for aneurysmal rupture.
Abstract:
The referral pattern of 334 patients admitted to a neurosurgical clinic with aneurysmal subarachnoid hemorrhage (SAH) was analyzed. Forty-nine percent of the patients were admitted after the day following the SAH. Failure of patients to seek prompt medical care was a cause of delay in 29 patients and of physician diagnostic errors in 95 patients. Common misdiagnoses included migraine, mental exhaustion, sinusitis, and influenza. A delay at the referring hospital was observed in 97 patients. Early intervention is important for the optimal management of patients with SAH. Educating the public, medical students, and physicians about the signs and symptoms of SAH and the importance of prompt therapy is likely to improve overall outcome after aneurysmal rupture.