Factors and outcomes associated with ultra-early surgery for poor-grade XXXX : a multicentre retrospective analysis.

@entity1 @entity548 @entity510 @entity75 @entity260 @entity438
OBJECTIVE: To determine factors and outcomes associated with ultra-early surgery for poor-grade @entity510 ( @entity510 ). DESIGN: A multicentre retrospective analysis, observational study. SETTING: High-volume teaching hospitals (more than 150 @entity510 cases per year). @entity1 : 118 @entity1 with World Federation of Neurosurgical Societies (WFNS) grades IV and V underwent surgical treatment. Ultra-early surgery was defined as surgery performed within 24   h of @entity510 , and delayed surgery as surgery performed after 24   h. Outcome was assessed by modified Rankin Scale (mRS). The mean time of follow-up was 12.5  3.4   months (range 6-28   months). RESULTS: 47 (40%) @entity1 underwent ultra-early surgery, and 71 (60%) @entity1 underwent delayed surgery. @entity1 with WFNS grade V (p=0.011) and @entity75 (p=0.004) more often underwent ultra-early surgery. @entity260 were similar in ultra-early and delayed surgery groups. Adjusted multivariate analysis showed the outcomes were similar between the two groups. Multivariate analysis of predictors of poor outcome, ultraearly surgery was not an independent predictor of poor outcome, while advanced age, postresuscitation WFNS V grade, @entity548 , @entity438 were associated with poor outcome. CONCLUSIONS: Although @entity1 with WFNS grade V and @entity75 more often undergo ultra-early surgery, postoperative complications and outcomes in selected @entity1 were similar in the two groups. @entity1 of younger age, WFNS grade IV, absence of @entity548 , @entity438 are more likely to have a good outcome. Ultra-early surgery could improve outcomes in carefully selected @entity1 with poor-grade @entity510 .
