Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage

Official title

Long-term Prognosis of Emergency Aneurysmal Subarachnoid Hemorrhage: an MDT- Based Multicenter Cohort Study

Overview

Rupture of intracranial aneurysms can lead to extensive subarachnoid hemorrhage (SAH), a potentially fatal neurological emergency with mortality rates ranging from 8 to 67%. At present, surgical clipping (SC) and endovascular coiling (EC) are two main treatments for aneurysmal subarachnoid hemorrhage (aSAH), in recent years, the improvements in surgical equipment and techniques have already greatly improved the postoperative safety of patients. However, considering individual differences between patients, some still at risk due to possible complications during hospitalization or after discharge from the hospital, it will no doubt generate a large healthcare burden. This prospective, observational clinical trial (LongTEAM) is to improve the diagnosis and treatment effect and efficiency in this field, reducing mortality, medical costs, and medical burden, while opening up new avenues for interdisciplinary clinical practice and scientific research exploration.

Interventions

• Procedure Surgical clipping and endovascular coiling
  Surgical clipping: Apply aneurysm clip to clip the ruptured aneurysm. Endovascular coiling：Also called endovascular embolization, to block blood flow into an aneurysm.Preventing blood flow into an aneurysm helps to keep it from rupturing.

Primary outcome measures

• Unfavorable neurological outcome (mRS>2) [Time frame: 10 days after the procedure]
• Unfavorable neurological outcome (mRS>2) [Time frame: 3 months]
• Unfavorable neurological outcome (mRS>2) [Time frame: 6 months]
• Unfavorable neurological outcome (mRS>2) [Time frame: 12 months]
• Unfavorable neurological outcome (mRS>2) [Time frame: 24 months]

Secondary outcome measures (10)

• Cognitive deficits [Time frame: 10 days after the procedure]
• Cognitive deficits [Time frame: 3 months]
• Cognitive deficits [Time frame: 6 months]
• Cognitive deficits [Time frame: 12 months]
• Cognitive deficits [Time frame: 24 months]
• Major adverse cardiac or cerebrovascular events [Time frame: 10 days after the procedure]
• Major adverse cardiac or cerebrovascular events [Time frame: 3 months]
• Major adverse cardiac or cerebrovascular events [Time frame: 6 months]
• Major adverse cardiac or cerebrovascular events [Time frame: 12 months]
• Major adverse cardiac or cerebrovascular events [Time frame: 24 months]

Eligibility criteria

Inclusion criteria

• All patients admitted to the emergency department of the investigator with aneurysmal subarachnoid hemorrhage are included in their prospective registry.

Exclusion criteria

• None

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Cohort

Study locations

China · 2 centers

• Beijing Tiantan Hospital — Beijing
• The First People's Hospital of Neijiang — Neijiang

Publications

• Tang X, Wang X, Zhu B, Zhou L, Chen X. The prognostic significance of uric acid to albumin ratio in patients with aneurysmal subarachnoid hemorrhage following surgical clipping or endovascular interventions: insights from a large cohort study. Front Neurol. 2026 Jan 12;16:1648805. doi: 10.3389/fneur.2025.1648805. eCollection 2025. PMID 41602990
• Yu T, Lau TY, Liu Y, Li R, Lin F, Song Z, Zhu Q, Chen Y, Li T, Jing J, Chen X. Low-Field Portable MRI Detects Developmental Pattern of Ultraearly Cerebral Infarction in aSAH. Stroke. 2026 Mar;57(3):721-731. doi: 10.1161/STROKEAHA.125.052474. Epub 2025 Dec 11. PMID 41376582
• Tang X, Zhu B, Liu M, Lin F, Li R, Song W, Xue J, Zhou L, Chen X. Increased triglyceride-glucose index is associated with adverse functional outcome for patients with aneurysmal subarachnoid hemorrhage after surgical clipping and endovascular coiling: insights from a large cohort study. Front Neurol. 2025 Sep 10;16:1622819. doi: 10.3389/fneur.2025.1622819. eCollection 2025. PMID 41001201
• Yang Y, Zhu B, Lin F, Li R, Chen X. Association between geriatric nutritional risk index and clinical outcome of elderly aneurysmal subarachnoid hemorrhage patients: insights from a large cohort study. Neurosurg Rev. 2025 Feb 4;48(1):169. doi: 10.1007/s10143-025-03209-6. PMID 39903290
• Li R, Lin F, Chen Y, Lu J, Yang J, Han H, Yuan K, Wang K, Yan D, Li R, He S, Li Z, Zhang H, Chen X, Ma L, Zhao Y, Hao Q, Ye X, Wang H, Li H, Zhang L, Shi G, Zhou J, Li Y, Wang S, Chen X, Zhao Y. The effect of sex differences on complications and 90-day outcomes after aneurysmal subarachnoid hemorrhage: a propensity score-matched analysis. Neurosurg Rev. 2022 Oct;45(5):3339-3347. doi: 10.1007/s1014 PMID 35870093
• Li R, Lin F, Chen Y, Lu J, Han H, Ma L, Zhao Y, Yan D, Li R, Yang J, He S, Li Z, Zhang H, Yuan K, Wang K, Hao Q, Ye X, Wang H, Li H, Zhang L, Shi G, Zhou J, Zhao Y, Zhang Y, Li Y, Wang S, Chen X, Zhao Y. A 90-Day Prognostic Model Based on the Early Brain Injury Indicators after Aneurysmal Subarachnoid Hemorrhage: the TAPS Score. Transl Stroke Res. 2023 Apr;14(2):200-210. doi: 10.1007/s12975-022-01 PMID 35567655
• Li R, Lin F, Chen Y, Lu J, Han H, Ma L, Zhao Y, Yan D, Li R, Yang J, He S, Li Z, Zhang H, Yuan K, Wang K, Hao Q, Ye X, Wang H, Li H, Zhang L, Shi G, Zhou J, Zhao Y, Zhang Y, Li Y, Wang S, Chen X, Zhao Y. Elevated blood hemoglobin on admission as an independent predictor of unfavorable outcomes in patients with aneurysmal subarachnoid hemorrhage. Neurosurg Rev. 2022 Aug;45(4):2689-2699. doi: 10.100 PMID 35366711
• Yang J, Lu J, Li R, Lin F, Chen Y, Han H, Yan D, Li R, Li Z, Zhang H, Yuan K, Li H, Zhang L, Shi G, Zhou J, Wang S, Zhao Y, Chen X. Application of Intracranial Pressure-Directed Therapy on Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage. Front Aging Neurosci. 2022 Mar 14;14:831994. doi: 10.3389/fnagi.2022.831994. eCollection 2022. PMID 35360218

Identifiers

NCT: NCT04785976 · KY 2020-11-26

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗