“Time is Brain” for SAH 🩸 too!
Does the aSAH clock start at the door, or at the first headache?
A 7-center cohort from China says the prehospital window is the outcome lever we keep undercounting.
726 adults with aneurysmal SAH. Rapid transfer (to an endovascular-capable hospital in 8 hours or less) vs delayed (after 8 hours):
🚑 386 made it in 8 hours (53%). 340 did not.
🧠 6-month mRS >2: 8% vs 23% (adjusted OR 5.3)
💔 12-month death: 4.9% vs 8.8% (adjusted OR 2.6)
⚠️ Delayed transfer also tracked with more herniation, hydrocephalus, ischemic stroke, and rebleeding
Only about half of this network hit the 8-hour window.
If your region still treats aSAH transfer as get-there-sometime-today, this is the number to take to the transfer committee.
What cutoff does your system actually hit?
Drop your comments below 👇🏽
Reference:
Mi S, Xiao ZK, Wang B, Duan Y, Liu A. The impact of rapid transfer on the prognosis of aneurysmal subarachnoid hemorrhage: a multicenter cohort study. World Neurosurg. 2026. doi:10.1016/j.wneu.2026.125269
doi.org/10.1016/j.wneu.2026.…