Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage

Study Overview
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Brief Summary
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Rupture of intracranial aneurysms can lead to extensive subarachnoid hemorrhage (SAH), a potentially fatal neurological emergency with mortality rates ranging from 8 to 67%. At present, surgical clipping (SC) and endovascular coiling (EC) are two main treatments for aneurysmal subarachnoid hemorrhage (aSAH), in recent years, the improvements in surgical equipment and techniques have already greatly improved the postoperative safety of patients. However, considering individual differences between patients, some still at risk due to possible complications during hospitalization or after discharge from the hospital, it will no doubt generate a large healthcare burden. This prospective, observational clinical trial (LongTEAM) is to improve the diagnosis and treatment effect and efficiency in this field, reducing mortality, medical costs, and medical burden, while opening up new avenues for interdisciplinary clinical practice and scientific research exploration.

Official Title
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Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage: an MDT- Based Multicenter Cohort Study

Conditions
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Aneurysmal Subarachnoid Hemorrhage

Intervention / Treatment
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* Procedure: Surgical clipping and endovascular coiling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients admitted to the emergency department of the investigator with aneurysmal subarachnoid hemorrhage are included in their prospective registry. Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Surgical clipping<br> | Procedure: Surgical clipping and endovascular coiling<br>* Surgical clipping: Apply aneurysm clip to clip the ruptured aneurysm. Endovascular coiling：Also called endovascular embolization, to block blood flow into an aneurysm.Preventing blood flow into an aneurysm helps to keep it from rupturing.<br>|
| Endovascular coiling<br> | Procedure: Surgical clipping and endovascular coiling<br>* Surgical clipping: Apply aneurysm clip to clip the ruptured aneurysm. Endovascular coiling：Also called endovascular embolization, to block blood flow into an aneurysm.Preventing blood flow into an aneurysm helps to keep it from rupturing.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Unfavorable neurological outcome (mRS>2) | Number of patients experiencing a unfavorable neurological outcome at discharge, defined as a modified Rankin Scale (mRS) score of >2. | 10 days after the procedure | 
| Unfavorable neurological outcome (mRS>2) | Number of patients experiencing a unfavorable neurological outcome at 3 months post-treatment, defined as a modified Rankin Scale (mRS) score of >2. | 3 months | 
| Unfavorable neurological outcome (mRS>2) | Number of patients experiencing a unfavorable neurological outcome at 6 months post-treatment, defined as a modified Rankin Scale (mRS) score of >2. | 6 months | 
| Unfavorable neurological outcome (mRS>2) | Number of patients experiencing a unfavorable neurological outcome at 12 months post-treatment, defined as a modified Rankin Scale (mRS) score of >2. | 12 months | 
| Unfavorable neurological outcome (mRS>2) | Number of patients experiencing a unfavorable neurological outcome at 24 months post-treatment, defined as a modified Rankin Scale (mRS) score of >2. | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cognitive deficits | Number of patients experiencing a unfavorable neurological outcome at discharge,defined as changes in thinking, emotion, will and behavior. | 10 days after the procedure | 
| Cognitive deficits | Number of patients experiencing a unfavorable neurological outcome at 3 months, defined as changes in thinking, emotion, will and behavior. | 3 months | 
| Cognitive deficits | Number of patients experiencing a unfavorable neurological outcome at 6 months, defined as changes in thinking, emotion, will and behavior. | 6 months | 
| Cognitive deficits | Number of patients experiencing a unfavorable neurological outcome at 12 months, defined as changes in thinking, emotion, will and behavior. | 12 months | 
| Cognitive deficits | Number of patients experiencing a unfavorable neurological outcome at 24 months, defined as changes in thinking, emotion, will and behavior. | 24 months | 
| Major adverse cardiac or cerebrovascular events | Number of patients experiencing an event including all-cause death, non-fatal cerebrovascular event, non-fatal any myocardial infarction and revascularization at discharge. | 10 days after the procedure | 
| Major adverse cardiac or cerebrovascular events | Number of patients experiencing an event including all-cause death, non-fatal cerebrovascular event, non-fatal any myocardial infarction and revascularization at 3 months. | 3 months | 
| Major adverse cardiac or cerebrovascular events | Number of patients experiencing an event including all-cause death, non-fatal cerebrovascular event, non-fatal any myocardial infarction and revascularization at 6 months. | 6 months | 
| Major adverse cardiac or cerebrovascular events | Number of patients experiencing an event including all-cause death, non-fatal cerebrovascular event, non-fatal any myocardial infarction and revascularization at 12 months. | 12 months | 
| Major adverse cardiac or cerebrovascular events | Number of patients experiencing an event including all-cause death, non-fatal cerebrovascular event, non-fatal any myocardial infarction and revascularization at 24 months. | 24 months |