Clinical features and prognosis of early-arrival patients with subarachnoid hemorrhage.
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概要
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The object of this study was to define the relationship between patient transport time to a neurosurgical center and the incidence of rebleeding after subarachnoid hemorrhage (SAH). The usefulness of sedation for the prevention of rebleeding was also discussed. Thirty-one patients with SAH came to our clinic by ambulance, within 4 hours after the onset, between January 1992 and December 1993. We divided these patients into two groups; an ultraearly (UE) group consisting of 13 patients arriving within one hour after the onset, and early (E) group consisting of 15 patients arriving between one and 4 hours after the onset. Neurological conditions at admission were similarly distributed in the two groups. Outcome was evaluated using the Glasgow coma scale. In the UE group, the number showing good recovery (GR) was 9 and dead (D) 1, while in the E group the respective numbers were 5 and 6. Prognosis in the UE group was thought better than that of the E group. Many UE patients were comatose preoperatively because of an initial drowsy state after the onset and sedation immediately after the diagnosis of SAH. Thus, UE admission reduced the incidence of aneurysmal rebleeding. On the other hand, patients in the E group arrived having already recovered from the initial shock state, such that stressful medical treatments and examinations were performed while the patients' consciousness was clear. The incidence of rebleeding tended to be increased in the E group. It is important to shorten the transport time to neurosurgical centers to improve the outcome of SAH.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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