The effects of timing of aneurysm surgery on vasospasm and mortality in patients with subarachnoid hemorrhage.

Objective: The purpose of the present study was to compare the effects of early and late surgery on postoperative vasospasm and mortality in patients with subarachnoid hemorrhage (SAH).

Methods: The data of patients with SAH who underwent aneurysmal clipping at the Kartal Training and Research Hospital between 1999 and 2005 were retrospectively analyzed. The patients who underwent early (0-3 days) and late surgery (> or = 4 days) were evaluated as two groups. Patient outcomes were assessed 1 month after surgery.

Results: Of 159 patients (mean age, 49 years; 71 males) with SAHs, 135 (mean age, 51 years; 55 males) underwent early surgery and 24 patients (mean age, 56 years; 16 males) underwent late surgery. The overall postoperative vasospasm rate was 10.7%. The rate of postoperative vasospasm was significantly higher in the late surgery group (41.7%) compared to the early surgery group (5.2%; p < 0.001). There were 15 post-operative deaths (9.4%). The mortality rate in the late surgery group (25.0%) was significantly higher than the early surgery group (6.7%; p = 0.005).

Conclusions: The present study has demonstrated that early surgery is advantageous over late surgery in patients with SAH with lower post-operative vasospasm and mortality rates.