The Effect of Timely Emergency Referral on Aneurysmal Subarachnoid Hemorrhage Outcomes: Intervention Within 8 Hours versus After 8 Hours

Background Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening neurological emergency, where early intervention is crucial for improving outcomes. Timely referral in the emergency setting remains a challenge, and the “golden treatment window” lacks a unified definition. This study evaluates the impact of referral time on aSAH prognosis and explores how timely emergency referrals can improve outcomes, reduce complications, and increase survival rates. Methods This retrospective study included 749 adult aSAH patients from seven centers. Patients were divided into two groups based on the time to reach a hospital with surgical capabilities: early intervention (≤ 8 hours) and delayed intervention (> 8 hours). Logistic regression compared 6-month prognosis, 1-year survival, and complication rates between the groups. Results Early intervention (≤ 8 hours) significantly reduced the incidence of poor prognosis at 6 months. Delayed intervention (> 8 hours) was associated with higher risks of complications, including thrombosis, brain herniation, hydrocephalus, ischemic stroke, and rebleeding. Emergency referral, particularly when patients were rapidly transferred to hospitals with surgical capabilities, significantly improved outcomes. Conclusion Emergency referral within 8 hours improves aSAH prognosis, reducing poor outcomes and complications. Timely referral is a key strategy for managing aSAH, emphasizing the critical role of the “golden 8-hour window,” particularly in multi-tiered healthcare systems.