Time from onset to aneurysm securing is associated with rebleeding in patients with aneurysmal subarachnoid hemorrhage

Rebleeding is a major complication in patients admitted for aneurysmal subarachnoid hemorrhage. The optimal timing for aneurysm securing after the initial headache remains debated. The objective of this study was to evaluate the previously established predictive factors for rebleeding in a contemporary retrospective cohort (2020-2022, Rennes University Hospital). Among the 226 patients included in the analysis, 33 (15%) experienced rebleeding. The mean time-to-event (rebleeding or securing) was significantly shorter in patients without rebleeding compared with patients with rebleeding (36 {+/-} 3 vs. 63 {+/-} 9 hours, respectively, p<0.001). For each additional hour of delay since the first symptoms, the odds of rebleeding increased by 0.7% (OR = 1.007 [1.001-1.013], p=0.026). This association remains significant in multivariate analysis. Despite its limitations, this study highlights the importance of early management, taking into account the time elapsed since the initial headache.