An Australian study has found only 59% of patients receive optimal evidence-based care following an aneurysmal subarachnoid haemorrhage (aSAH).

The retrospective study of 549 patients from two comprehensive cerebrovascular centres assessed three indicators of optional care – antihypertensives prior to aneurysm treatment, receipt of nimodipine, and aneurysm treatment with coiling/clipping.

The indicators were selected from current but dated US (2012) and European (2013) guidelines.

The study found 85% of patients had received nimodipine, 85% received aneurysm treatment but only 31% received antihypertensives in the ED.

Of those, most received nimodipine and antihypertensives within 1 day and aneurysm treatment within 72 hr of aSAH.

The study, published in the Journal of the Neurological Sciences, also showed receipt of optimal care was associated with a reduced risk of death at 1 year.

Overall, 27% of patients had died within 1 year of their aSAH with the initial bleed the most common cause of death.

“This stresses the importance of acute care for aSAH to reduce early death,” it said.

As well, more patients discharged to rehabilitation (63%) and home (76%) received optimal care compared to those who died (30%, p ≤0.001).

The study found patients who were not receiving evidence-based processes of care were more often older and with more severe aSAH.

“Therefore, exploring ways to increase access to optimal care to all patients with aSAH irrespective of age and grade could help in improving the outcome,” the investigators said.

The study, led by PhD candidate Sabah Rehman from the Menzies Institute for Medical Research at the University of Tasmania, said their findings were supported by improved short-term and long-term outcomes in ischemic stroke patients when uncompromised quality of care is provided

“We should continue to look for new avenues for evidence-based care for aSAH patients, but also measure adherence and test interventions to address gaps in receipt of care,” the study concluded.