We investigated the current state of and problems in patients with subarachnoid hemorrhage initially diagnosed and treated by general physicians at a local referring hospital and subsequently transferred to our hospital for neurosurgical treatment.
We studied 37 consecutive patients with subarachnoid hemorrhage over a 7-year period from April 2001 to March 2008.
A total of 7 men and 30 women aged 50 to 89 years (average: 71.2±9.5 years) were included in this study. Thirteen patients (35.1%) were referred to our hospital with diagnoses other than subarachnoid hemorrhage. Twenty-three of 27 patients who had CT scans were diagnosed correctly in the referring hospital, while only 1 of 10 patients was correctly diagnosed without CT.
Time from the onset to admission to our hospital ranged from 85 minutes to 144 hours (average: 15.3±29 hours). The reasons of delay in patients who took more than 12 hours to reach us were patients’ delay in visiting the referring hospital in 3 cases and uncertain initial diagnosis in 6. All 6 cases complained of sudden headache, but did not undergo CT. All patients were transferred by an ambulance car, and the duration of transfer ranged from 60 to 120 minutes (average: 85.4±15.7 minutes). None of the patients experienced rebleeding during transfer.
Subarachnoid hemorrhage can be diagnosed correctly at the local primary hospital with CT, allowing appropriate primary treatments. Initial misdiagnosis is the major cause of delay in transferring patients to neurosurgical facilities.