Impact of Hospital-Related Factors on Outcome After Treatment of Cerebral Aneurysms

Background and Purpose— The goal of this study was to examine the impact of hospital characteristics on outcome after the treatment of ruptured and unruptured cerebral aneurysms.Methods— We identified all discharges in New York State from 1995 through 2000 with a principal diagnosis of subarachnoid...

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Bibliographic Details
Published in:Stroke (1970) 2003-09, Vol.34 (9), p.2200-2207
Main Authors: Berman, Mitchell F., Solomon, Robert A., Mayer, Stephan A., Johnston, S. Claiborne, Yung, Pixie P.
Format: Article
Language:English
Subjects:
Female
Hospital Mortality
Hospitals - standards
Hospitals - utilization
Humans
Intracranial Aneurysm - mortality
Intracranial Aneurysm - surgery
Length of Stay
Male
Middle Aged
Neurosurgical Procedures - adverse effects
Neurosurgical Procedures - mortality
Neurosurgical Procedures - statistics & numerical data
New York
Outcome Assessment (Health Care) - statistics & numerical data
Patient Admission - statistics & numerical data
Patient Discharge - statistics & numerical data
Patient Selection
Referral and Consultation - statistics & numerical data
Subarachnoid Hemorrhage - mortality
Subarachnoid Hemorrhage - surgery
Surgical Instruments - statistics & numerical data
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Summary:Background and Purpose— The goal of this study was to examine the impact of hospital characteristics on outcome after the treatment of ruptured and unruptured cerebral aneurysms.Methods— We identified all discharges in New York State from 1995 through 2000 with a principal diagnosis of subarachnoid hemorrhage (SAH) or unruptured cerebral aneurysm (UCA) in patients who were treated by aneurysm clipping, wrapping, or endovascular coiling. An adverse outcome was defined as in-hospital death or discharge to a rehabilitation hospital or long-term facility. We examined the effect of hospital factors, including the rate of endovascular therapy and overall procedural volume, on outcome, length of stay, and total charges.Results— There were 2200 (36.9%) and 3763 (63.1%) admissions for attempted treatment of UCA and SAH, respectively. The 10 highest-volume hospitals performed half of all the procedures. Overall, hospital volume was associated with fewer adverse outcomes and lower in-hospital mortality for both UCA (adverse outcomeodds ratio [OR], 0.89; P
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.0000086528.32334.06