Predicting outcome in poor-grade patients with subarachnoid hemorrhage: a retrospective review of 159 aggressively managed cases.

@article{LeRoux1996PredictingOI,
  title={Predicting outcome in poor-grade patients with subarachnoid hemorrhage: a retrospective review of 159 aggressively managed cases.},
  author={Peter D. Le Roux and Joseph P. Elliott and David W. Newell and Michael Sean Grady and H. Richard Winn},
  journal={Journal of neurosurgery},
  year={1996},
  volume={85 1},
  pages={
          39-49
        }
}
To determine what factors predict outcome, the authors retrospectively reviewed the management of all 159 poor-grade patients admitted to Harborview Medical Center at the University of Washington who suffered aneurysmal subarachnoid hemorrhage between 1983 and 1993. Favorable outcome (assessed by the Glasgow Outcome Scale) occurred in 53.9% of Hunt and Hess Grade IV, and 24.1% of Grade V patients. Outcome was largely determined by the initial hemorrhage and subsequent development of intractable… 
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Current Surgical Outcome in Poor Grade Patients with Subarachnoid Hemorrhage
TLDR
It is concluded that aggressive management can benefit patients with GCS 3 or 6 even in Grade V, and in elderly patients 75 years old and older, preoperative GCS with 8 or better may be the borderline to expect favorable outcome.
Toward more rational prediction of outcome in patients with high-grade subarachnoid hemorrhage.
TLDR
Timing of grading is an important factor in outcome prediction that needs to be standardized, especially when the patient is assessed using the WFNS scale or the GCS, and this study suggests that the patient's worst clinical grade is most predictive of outcome.
Poor-Grade Aneurysmal Subarachnoid Hemorrhage: Factors Influencing Functional Outcome--A Single-Center Series.
Timing of clinical grade assessment and poor outcome in patients with aneurysmal subarachnoid hemorrhage.
TLDR
Outcome after aneurysmal SAH is best predicted by assessing WFNS grade after neurological resuscitation, and receiver operating characteristic/area under the curve (AUC) analysis demonstrated that WfNS grade determined postresuscitation had a stronger association with poor outcome than WF NS grade assessed upon admission or at nadir.
Poor-grade Aneurysmal Subarachnoid Hemorrhage: Outcome after Treatment with Urgent Surgery
TLDR
The high ultraearly rebleeding rate indicates a need to urgently secure the ruptured aneurysm by performing surgery or coiling, and this indication is more pronounced for poor- grade patients than for good-grade patients.
Early management of poor-grade aneurysmal subarachnoid hemorrhage: A prognostic analysis of 104 patients
Defining survivorship after high-grade aneurysmal subarachnoid hemorrhage.
Predictors of outcome in World Federation of Neurologic Surgeons grade V aneurysmal subarachnoid hemorrhage patients*
TLDR
The high rebleeding rate and subsequent poor outcome in World Federation of Neurologic Surgeons grade V patients warrants early treatment to secure the ruptured aneurysm, and favorable outcome was seen in 39% of patients with a Glasgow Coma Scale motor value ≥4 at day 2.
Preoperative Prediction of Long-term Outcome in Poor-grade Aneurysmal Subarachnoid Hemorrhage
TLDR
Outcome in poor-grade aneurysmal SAH is strongly predicted by patient age, worst preoperative Hunt and Hess clinical grade, and aneurYSm size, and the Prognosis Score is a useful tool for preoperatively assessing the likelihood of a favorable outcome.
Factors affecting outcome in poor grade subarachnoid haemorrhage: An institutional study
TLDR
Poor grade SAH patients with or without ICH, IVH, if operated within 3 days can give rise to favorable outcome in around 50%, however, presence of patchy infarcts associated with thick subarachnoid blood (Fisher grade 3) precludes long term survival or meaningful recovery.
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