Impact of Ruptured Aneurysm Circulation on Mortality: A Nationwide Inpatient Sample Analysis |
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| Affiliation: | 2. Department of Neurosurgery, University of Texas Health at San Antonio, Texas, USA;2. The University of Chicago, Chicago, IL, USA;3. Emory University, Atlanta, GA, USA;4. The University of Massachusetts Medical School-Baystate, Springfield, MA, USA;5. Miller School of Medicine, University of Miami, Miami, FL, USA;8. Medical University of South Carolina, Charleston, SC, USA;2. Department of Neurosurgery, Hospital of Guangzhou University Mega Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510006, China;3. Postdoctoral Center, Yangjiang Hospital of Chinese Medicine, Yangjiang 529500, China;2. Department of Neurology, Miller School of Medicine, University of Miami, Miami, Fl, USA;3. Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA;4. Renaissance School of Medicine, Stony Brook University, New York, NY, USA;5. Community Center, The Atahualpa Project, Atahualpa, Ecuador;2. University of Illinois at Chicago College of Medicine, Department of Neurology and Rehabilitation, 912 S. Wood Street, Chicago, 60612, United States;3. University of Illinois at Chicago College of Medicine, Department of Neurology and Rehabilitation, 912 S. Wood Street, Chicago, 60612, United States |
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| Abstract: | ObjectiveThis study investigates the effect of aneurysm circulation on mortality and patient outcomes after aneurysmal subarachnoid hemorrhage (SAH) within the United States.MethodsA retrospective cohort study was conducted using the Nationwide Inpatient Sample (NIS), a part of the Healthcare Cost and Utilization Project (HCUP), with ICD-10 codes for non-traumatic SAH between 2015-2016. Aneurysms were stratified as either anterior or posterior circulation. Multivariate logistic regression was used to find the impact of selected variables on the odds of mortality.ResultsThe NIS reported 1,892 cases of non-traumatic SAH within the study period that were predominantly anterior circulation (82.6%), female (68.6%), white (57.7%), with mean age of 59.07 years, and in-hospital mortality of 21.4%. Anterior circulation aneurysms were associated with lower severity of initial illness (p = 0.014) but higher likelihood of vasospasm (p = 0.0006) than those of the posterior circulation. In a multivariate logistic regression analysis, mortality was associated with posterior circulation aneurysms (OR: 1.42; CI 95% 1.005-20.10, p = 0.047), increasing age (OR: 1.035; 95% CI 1.022-1.049; p < 0.0001), and shorter hospital stays (OR: 0.7838; 95% CI 0.758-0.811; p < 0.0001). Smoking history (OR: 0.825; 95% CI 0.573-1.187, p > 0.05) and vasospasm (OR: 1.005; 95% CI 0.648-1.558; p > 0.05) were not significantly associated with higher odds of mortality.ConclusionsMortality following aneurysmal SAH is associated with posterior circulation aneurysms, and increasing age, but not smoking history or vasospasm. These findings may be useful for prognostication and counseling patients and families. |
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