How to Simplify In-Hospital Aneurysmal Subarachnoid Hemorrhage Outcome: The Hospital Assessment Scale.

Area of Science:

• Neurosurgery
• Clinical Outcomes Research
• Medical Assessment Tools

Background:

• Aneurysmal subarachnoid hemorrhage (aSAH) presents significant mortality and disability challenges.
• Current clinical outcome assessment lacks standardization, hindering effective patient care and research.
• Existing detailed assessment scales are often impractical for routine neurosurgical settings.

Purpose of the Study:

• To address the lack of a standardized outcome assessment for aneurysmal subarachnoid hemorrhage (aSAH).
• To propose a novel, simplified assessment scale for in-hospital use in aSAH patients.
• To enhance the quality and comparability of outcome data in aSAH research.

Main Methods:

• Conducted a structured PubMed search using keywords: "aneurysmal subarachnoid hemorrhage," "assessment scale," and "outcome."
• Screened titles, abstracts, and full texts of eligible studies.
• Analyzed extracted data to summarize existing outcome assessment instruments' use, strengths, and limitations.

Main Results:

• Current outcome assessments are often simplistic (favorable/unfavorable) or impractical (extended Glasgow Outcome Scale, modified Rankin Scale).
• International efforts highlight the need to include cognitive, emotional, and functional domains.
• Proposed the Hospital Assessment Scale (HAS), a four-point ordinal scale (0-3) for in-hospital use, addressing current gaps.

Conclusions:

• The proposed Hospital Assessment Scale (HAS) offers a standardized, non-dichotomized approach to outcome assessment in aSAH.
• HAS implementation can improve discharge planning and clinical study consistency.
• Adoption of HAS may enhance decision-making and future study design in aSAH research.