AUTHOR=Mehta Tapan , Desai Ninad , Patel Smit , Male Shailesh , Khan Adam , Grande Andrew Walker , Tummala Ramachandra Prasad , Jagadeesan Bharathi Dasan 

TITLE=Readmission Trends Related to Unruptured Intracranial Aneurysm Treatment

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.590751

DOI=10.3389/fneur.2021.590751

ISSN=1664-2295

ABSTRACT=BACKGROUND  AND PURPOSE
Given the high mortality rate following  aneurysmal SAH, prophylactic treatment of unruptured  intracranial aneurysms (UIA) is considered  for selected patients thought to be at high risk for aneurysmal rupture. Hospital readmission  rates can serve as a surrogate marker for the safety and  cost-effectiveness of treatment options for UIAs; we  present an analysis of the 30-day rehospitalization rates and predictors of  readmission following UIA treatment with surgical and endovascular approaches.

METHODS
We retrospectively analyzed data from  the National Readmission  Database (NRD) derived from  the Healthcare Cost and Utilization  Project for the year 2014. The cohort included patients with a primary  discharge diagnosis of a treated unruptured aneurysm. The primary outcome variable was the 30-day readmission rate in open surgical vs. endovascularly treated groups. The secondary outcomes included  predictors of readmissions, and causes of 30-day readmissions in these  two groups.

RESULTS
The 30-day  readmission  rate for the  surgical group was  8.37% compared to 4.87% for the endovascular  group. The index hospitalization  duration was longer in the surgical  group.  A larger proportion of the patients readmitted following  surgical treatment were hypertensive (76.35%, versus 63.43%), but the prevalence of other medical  comorbidities was comparable in the two treatment groups.

CONCLUSIONS
There is a higher  likelihood for 30-day readmission, longer duration  of initial hospitalization and a lower likelihood of  discharge home following surgical treatment of UIAs when  compared to endovascular treatment. These findings, however,  do not demonstrate long-term superiority of one specific treatment  modality.