Abstract Details

Title Treatment of Cerebral Aneurysm in Kids: Analysis of Kids Inpatient Database

Topic Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 091

Objective

Background BACKGROUND: Coiling has emerged as an alternative modality to clipping in the treatment of Children's Intracranial Aneurysms. ISAT had evaluated both treatment modalities for ruptured aneurysms in adult and showed superiority of coiling over clipping with a lower mortality and epilepsy rates at 1 year. There is lack of good evidence in children to address these treatment options in a large sample size.

Design/Methods DESIGN/METHODS: From the Kid's Inpatient Sample database for the years 1998 through 2009, we identified a cohort of children admitted with the diagnoses of intracranial aneurysms and aneurysmal subarachnoid hemorrhage. Hospital mortality and complication rates were compared among the clipping and coiling treatment groups. A multivariate logistic regression analysis used to identify independent variables associated with hospital mortality.

Results RESULTS: 1120 children included in the analysis. Two hundred children had aneurysm clipping and 920 had endovascular coiling procedures. Hospital mortality was higher in the clipped population, 6.09% versus 1.65% (adjusted odds ratio 3.02; 95% CI 1.24, 7.36; P = 0.002). Hydrocephalus, status epilepticus and pulmonary complications were higher in the clipped population (P = 0.001). The length of hospital stay as well as the hospital charges was higher in the clipped population (P = 0.0001). The rate of hospitals' use of the endovascular coiling has increased in various types of hospitals over the years included in this study (P = 0.0001). The trend in mortality rates among the clipped population remained higher (5.4%-6.2%) compared to the coiled group (1-2.4%).

Conclusions CONCLUSIONS: Endovascular coiling of cerebral aneurysms in children is associated with fewer deaths and complications, shorter hospital stay, and less hospital charges compared to clipping. The trend of hospitals' utilization of coiling procedures has increased during the recent years.

Authors/Disclosures
Aws Alawi, MD (Swedish Neuroscience Institute) PRESENTER	No disclosure on file
Hesham A. Allam, MD (Saint Louis University Hospital)	Dr. Allam has nothing to disclose.
Junaid Kalia, MD (NeuroCareAI)	No disclosure on file
Nirav Vora, MD	No disclosure on file
Amer Alshekhlee, MD (SSM Health)	No disclosure on file
Rozalina Dimitrova, MD, MPH (Allergan, Inc)	No disclosure on file

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