A Questionnaire Survey of Management of Patients with Aneurysmal Subarachnoid Haemorrhage in Poland

Mariusz Hofman, Norbert Hajder, Izabela Duda and Łukasz J. Krzych
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Mariusz Hofman: Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-007 Katowice, Poland
Norbert Hajder: Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-007 Katowice, Poland
Izabela Duda: Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-007 Katowice, Poland
Łukasz J. Krzych: Department of Anaesthesiology and Intensive Care, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-007 Katowice, Poland

IJERPH, 2020, vol. 17, issue 11, 1-13

Abstract: Background: Aneurysmal subarachnoid haemorrhage (aSAH) remains a potentially devastating threat to the brain with a serious impact on mortality and morbidity. We attempted to investigate correspondence between the current guidelines for aSAH management and real clinical practice in Poland. Methods: A web-based questionnaire was performed between 03.2019 and 06.2019. Centres performing neuro-interventional radiology procedures and neuro-critical care were included ( n = 29). One response from each hospital was recorded. Results: In three (10.4%) centres, there was no clear protocol for an interventional treatment plan. Endovascular embolisation was predominantly used in 11 (37.9%) hospitals, and microsurgical clipping, in 10 (34.5%). A written protocol for standard anaesthetic management was established only in six (20.7%) centres for coiling and in five (17.2%) for microsurgical clipping. The diagnosis of cerebral vasospasm was based on transcranial Doppler as the first-choice method in seven (24.1%) units. “3-H therapy” was applied by 15 (51.8%) respondents, and “2-H therapy”, by four (13.8%) respondents. In only eight (27.6%) centres were all patients with aSAH being admitted to the ICU. Conclusion: Many discrepancies exist between the available guidelines and clinical practice in aSAH treatment in Poland. Peri-procedural management is poorly standardised. Means must be undertaken to improve patient-oriented treatment and care.

Keywords: intracranial aneurysm; subarachnoid hemorrhage; ultrasonography; Doppler; transcranial; embolisation; therapeutic; vasospasm; intracranial (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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