Abstract Details

Title Effect of Age In The Outcomes Of Patients Undergoing Treatment Of Unruptured Intracranial Aneurysms: A Study Of the National Inpatient Sample 2009-2014

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S15 - Intracerebral Hemorrhage and SAH (1:55 PM-2:06 PM)

Poster/Presentation
Number 006

Objective We wanted to study impact of age on in-hospital outcomes of patients undergoing treatment of unruptured intracranial aneurysms

Background Increasing age has been shown to have negative effect on the treatment of cerebral aneurysms. Endovascular coiling and surgical clipping have been evolving over the years and no recent study exists to compare outcomes of treatment in senior population (≥ 65 years) compared to a younger population.

Design/Methods Using NIS, data pertaining to the patients with unruptured aneurysms treated with coiling or clipping was obtained. Demographics, treatment modality, complications, costs and surrogates of clinical outcome (length of stay, discharge disposition and in-hospital mortality) were analyzed, comparisons were made between patients according to the age, senior (≥ 65 ) vs (<65 years) and two treatment modalities.

Results

Patients <65 years undergoing coiling (n= 22375) had less in-hospital complications ( p< 0.001), shorter length of stay ( 2.5 ± 5.8 days versus 5.3± 5.1 days p< 0.001), lesser total hospital charges ( p< 0.001 ) compared to clipping. There was no difference in mortality rates (0.24% versus 0.22%, p= 0.82). In multivariate model, morbidity (discharge to a long term facility) was significantly lower in coiling patients (OR 0.30, CI 0.24-0.38).

Patients ≥ 65 years who underwent coiling had lesser in-hospital complications ( p< 0.001), shorter length of stay ( 2.8 ±4.2 versus 6.3 ± 5.5 days , p< 0.001), lesser total hospital charges ( p< 0.001), and lower mortality rates (0.20% versus 0.80%, p< 0.001) compared to clipping. In multivariate analysis there was no difference in mortality noted between the two treatment modalities but significantly lower morbidity (discharge to a long term facility) was observed in patients treated with coiling (OR 0.30, CI 0.07-1.02).

Conclusions We observed in this nationwide analysis that coiling has lower morbidity in all age groups but no difference in mortality compared to clipping. Further studies are necessary to corroborate our findings.

Authors/Disclosures
Rakesh Khatri, MD, FAAN PRESENTER	Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Alpha insight . Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Survey company .
Mohammad Rauf A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Shayan Ul Haque, MD, MBBS	No disclosure on file
Ihtesham A. Qureshi, MD	No disclosure on file
Harathi Bandaru, MD	Dr. Bandaru has nothing to disclose.
	No disclosure on file
Paisith Piriyawat, MD (Texas Tech University)	Dr. Piriyawat has nothing to disclose.
Alberto Maud, MD (Paul L. Foster School of Medicine Texas Tech UHSC El Paso, Texas)	Dr. Maud has nothing to disclose.
Salvador Cruz-Flores, MD, FAAN (Paul L. Foster School of Medicine Texas Tech University Health Sciences Center)	The institution of Dr. Cruz-Flores has received research support from University of Texas System.
Gustavo J. Rodriguez, MD (Gustavo J. Rodriguez)	Dr. Rodriguez has nothing to disclose.

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