1151. National Estimates of Recurrent Intracranial Hemorrhage among Patients with Ruptured Intracranial Aneurysms: Effect of Treatment Modality

Authors: Endrit Ziu, MD, PhD (Columbia, MO)

Introduction:
BACKGROUND:The estimates of recurrent intracranial hemorrhage in post hospitalization period among patients treated for ruptured intracranial aneurysms are not available outside clinical trials. 
OBJECTIVE: To determine the rates of recurrent intracranial hemorrhage related hospitalization within 1-year post hospitalization for treatment of ruptured intracranial aneurysm in a nationwide cohort of patients admitted for subarachnoid hemorrhage (SAH).

Methods:
We identified all readmissions related to new SAH or intracerebral hemorrhage in the nationally representative data for all patients hospitalized for SAH using the Nationwide Readmissions Database (NRD) 2013-2015 who had undergone endovascular or surgical treatment. Cox proportional hazards analysis was used to assess the relative risk (RR) of recurrent intracranial hemorrhage for patients in treatment cohorts after adjusting for potential confounders. 

Results:
A total of 15,561 patients with SAH were treated with either endovascular (n = 8657, 56%) or surgical treatment (n = 6907, 44%). The rate of all-cause in-hospital mortality (11% vs. 16%, P = 0.1895) was similar among patients treated with surgical or endovascular treatment. After adjusting for age, and APDRG severity score trend was observed for lower rate of intracerebral hemorrhage (RR, 0.63; 95% confidence interval, 0.54 0.74) among patients treated with endovascular modality and higher rate of readmissions due to causes other than intracranial hemorrhage (RR, 1.14; 95% confidence interval, 1.02-1.27).

Conclusion:
The rates of recurrent intracranial hemorrhage related hospitalization were low among patients with ruptured intracranial aneurysms in both the treatment groups but it was noticed that there was a higher rate of readmissions due to causes other than intracranial hemorrhage following one year post hospitalization.