Evaluation of clinical parameters of patients with aneurysmal subarachnoid hemorrhage during long-distance interhospital transport

BACKGROUND: The objective of the study was to investigate the changes in Glasgow Coma Scale (GCS) score, Fisher’s grade, and World Federation of Neurological Surgeons (WFNS) grade that occur during transport of patients with aneurysmal subarachnoid hemorrhage (aSAH) from secondary hospitals to a tertiary care center. METHODS: Seventy-five patients with aSAH who were transported through ground ambulance from secondary hospitals to our tertiary care centers between December 1, 2016, and December 1, 2019, were enrolled in this retrospective study. Data regarding GCS, Fisher’s grade, and WFNS grade from both hospitals, patient demographics, and duration and distance of transport were analyzed. RESULTS: The female-to-male ratio was 46:29 and median patient age was 55.0 years. Median transport time was 3.0 h and median distance traveled was 161.0 kilometers. GCS significantly decreased (p=0.004) and Fisher and WFNS grade significantly increased during transport (p=0.003 and p=0.003, respectively). The change in the WFNS grade during transport, but not GCS score or Fisher’s grade, was significantly different between non-intubated patients and intubated patients (p=0.036). CONCLUSION: Significant changes in Fisher’s grade, GCS, and WFNS grade occurred during ground transport of patients with aSAH from secondary hospitals to tertiary care centers. These changes in the parameters may affect and change patients future prognoses.