Abstract

Aim. We evaluated initial management of patients with spontaneous subarachnoid haemorrhage (SAH) and examined the relationship between clinical characteristics and delay in correct diagnostic workup of the patients.

Methods. We studied persons admitted with SAH to Tartu University Hospital over 4 years (2006 to 2009). Initial management of SAH was defined as incorrect if the patient had been evaluated by a  medical professional but the diagnosis had been missed and the patient had not been referred for proper diagnostic evaluation or hospitalisation.

Results. Of 174 patients diagnosed with SAH, 24.7% had had at least one episode of incorrect initial management. The risk was significantly higher among males, among patients with normal mental status after SAH and among patients examined by family physicians.

Conclusions. Incorrect initial management of SAH has remained a common case and mildly affected patients are at higher risk of initial diagnostic failure, suggesting the need for higher disease suspicion among patients with minimal clinical findings.