gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Management of prehaemorrhage antiplatelet use in aneurysmal subarachnoid haemorrhage – an international survey of current practice

Gebrauch von Plättchenhemmer vor stattgehabten Subarachnoidalblutung – internationale Umfrage über das Management und aktuelle Praxis

Meeting Abstract

  • presenting/speaker Martina Sebök - Universitätspital Zürich, Klinik für Neurochirurgie, Zürich, Switzerland
  • Emanuela Keller - Universitätspital Zürich, Neurochirurgische Intensivstation, Zürich, Switzerland
  • Bas van Niftrik - Universitätspital Zürich, Klinik für Neurochirurgie, Zürich, Switzerland
  • Luca Regli - Universitätspital Zürich, Klinik für Neurochirurgie, Zürich, Switzerland
  • Menno Germans - Universitätspital Zürich, Klinik für Neurochirurgie, Zürich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV098

doi: 10.3205/19dgnc113, urn:nbn:de:0183-19dgnc1136

Published: May 8, 2019

© 2019 Sebök et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: The case fatality in aneurysmal subarachnoid hemorrhage (aSAH) is 50% due to the initial hemorrhage or subsequent complications such as aneurysmal rebleed or delayed cerebral ischemia (DCI). One factor that might influence the initial brain damage or subsequent complications is the use of antiplatelet medication before the initial hemorrhage. The goal of this survey was to assess the different management options of patients with aSAH who used antiplatelets before the initial hemorrhage.

Methods: An anonymous survey of 11 multiple-choice questions about the management of aSAH patients who used antiplatelets before the initial hemorrhage was distributed to the international panel of attendees of the European Association of Neurosurgical Societies (EANS) annual meeting in Venice, Italy at 1–5 October 2017.

Results: A total of 258 (54%) completed surveys were returned. In about 80%, the departments of neurosurgery and neurology were responsible for the acute management of aSAH patients, whereas in 15% it was the intensive care units. Department guidelines were present in 32%. In 65%, the responders always stop the antiplatelet agent at admission and in 4.3% thrombocytes are always transfused. If a guideline is present, the neurospecialists consider thrombocyte transfusion more often (83% vs. 65% p=0.02).

Conclusion: Our survey among mainly European neurosurgeons show that there is a significant variability in the management of aSAH patients who have been using antiplatelets before the initial hemorrhage. These findings emphasize the importance of the development of evidence-based guidelines for management of patients with aSAH and antiplatelet use before the initial hemorrhage.