Abstract
We read with interest the recent article by Natarajan et al[1][1] regarding the outcome of treated patients admitted to their institution with aneurysmal subarachnoid hemorrhage during an 18-month period. The authors achieved excellent results in these patients and should be commended. We would like
Highlights
Their data do not strongly support their conclusion that the overall results of treatment for aneurysmal subarachnoid hemorrhage have improved significantly during the last decade
Logistic regression analysis was performed in an attempt to control for these pretreatment variables, at least 1 of them (HH) was a significant independent predictor of outcome
Despite these differences in important pretreatment variables favoring those in the clipped group, the patients with clipped aneurysms experienced longer stays in the intensive care unit, and significantly more of them developed vasospasm
Summary
Their data do not strongly support their conclusion that the overall results of treatment for aneurysmal subarachnoid hemorrhage have improved significantly during the last decade. The conclusion that the outcome of patients with coiled and clipped aneurysms in their study was similar is technically accurate, and misleading. This study was not designed in a fashion that would allow a meaningful comparison of outcomes between the 2 groups: There are no conclusions that can be drawn from these data to guide clinical practice.
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