Evidence mapPaperPMID 42566704Full record

ArticleEuropean stroke journal2026

Early rehabilitation initiation after aneurysmal subarachnoid haemorrhage: evaluation of mortality and functional outcomes.

Takuaki Tani, Masafumi Nozoe, Takaaki Ikeda, Hiroki Kubo, Hikaru Takara, Kazuhiro Tokuda, Ryusuke Matsuki, Kiyohide Fushimi

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Article in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Takuaki TaniDepartment of Pharmacoepidemiology, Showa Medical University Graduate School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.ORCID 0000-0002-0798-524X
Masafumi NozoeResearch Promotion Committee of the Japanese Society of Neurological Physical Therapy, 7-11-10 ropongi, minato ward, Tokyo 106-0032, Japan.
Takaaki IkedaResearch Promotion Committee of the Japanese Society of Neurological Physical Therapy, 7-11-10 ropongi, minato ward, Tokyo 106-0032, Japan.
Hiroki KuboResearch Promotion Committee of the Japanese Society of Neurological Physical Therapy, 7-11-10 ropongi, minato ward, Tokyo 106-0032, Japan.
Hikaru TakaraDepartment of Rehabilitation, University of the Ryukyus Hospital, 1076, Kiyuna, Ginowan City, Okinawa 901-2725, Japan.
Kazuhiro TokudaDepartment of Rehabilitation, Hanwa Memorial Hospital, 3-5-15 Minamisumiyoshi, Sumiyoshi Ward, Osaka 558-0041, Japan.
Ryusuke MatsukiDepartment of Rehabilitation, Kobe Rehabilitation Hospital, 1-8 Shiawasenomura, Kita Ward, Kobe 651-1106, Japan.
Kiyohide FushimiGraduate School of Medical and Dental Sciences, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo, Tokyo 113-8510, Japan.

Funding

Japan Society for the Promotion of Science 25 K20517
6 · The paper itself

Abstract

introductionEvidence regarding the optimal timing of rehabilitation after aneurysmal subarachnoid haemorrhage (aSAH) remains limited. In this study, we aimed to evaluate clinical outcomes associated with initiating rehabilitation within 48 h after aneurysm securing. PATIENTS AND

methodsWe conducted a retrospective cohort study emulating a target trial using the Diagnosis Procedure Combination claims database (651 acute-care hospitals), which contains administrative data with limited clinical granularity. We included adults (≥18 years) with aSAH who underwent endovascular coiling or surgical clipping on hospital day 1 and had prestroke mRS scores of 0-2. Early rehabilitation was defined as initiation within 48 h after aneurysm securing; the comparator was initiation after 48 h. Using a clone-censoring-weighting approach, we estimated per-protocol hazard ratios for 30-day mortality and poor functional outcome (mRS scores of 3-6). Sensitivity analyses were conducted using alternative initiation thresholds (72, 96 and 120 h).

resultsAmong 7544 patients (mean age, 62.6 years; 69.7% women), crude 30-day mortality was 2.6% in the early initiation group and 1.5% in the deferred initiation group. In the per-protocol analysis, early rehabilitation was associated with higher 30-day mortality (hazard ratio [HR], 1.82; 95% CI, 1.21-2.63) and a higher risk of poor functional outcome (HR, 1.31; 95% CI, 1.08-1.55). This association was attenuated when "early" was defined after 72 h (mortality HR, 1.34; 95% CI, 0.87-2.07). DISCUSSION: Initiating rehabilitation within 48 h after aneurysm securing was associated with worse short-term outcomes, whereas deferring initiation until after 72 h attenuated the excess risk.

conclusionsThese findings suggest that the first 48 h may represent a higher-risk window for routine rehabilitation initiation in acute aSAH care.

Indexed as

Subarachnoid HemorrhageAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTime FactorsTreatment Outcomecausal inferenceearly mobilisationintracranial aneurysmsubarachnoid haemorrhagesurvival analysis

Identifiers

PMID42566704
PMCPMC13450689

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.