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. 2022 Aug 5:13:952794.
doi: 10.3389/fneur.2022.952794. eCollection 2022.

Short- and long-term mortality of subarachnoid hemorrhage according to hospital volume and severity using a nationwide multicenter registry study

Sang-Won Park  1 , Ji Young Lee  1 , Nam Hun Heo  1 , James Jisu Han  2 , Eun Chae Lee  1 , Dong-Yong Hong  1 , Dong-Hun Lee  1 , Man Ryul Lee  3 , Jae Sang Oh  1
Affiliations

Short- and long-term mortality of subarachnoid hemorrhage according to hospital volume and severity using a nationwide multicenter registry study

Sang-Won Park et al. Front Neurol. .

Abstract

Introduction: Recent improvements in treatment for subarachnoid hemorrhage (SAH) have decreased the mortality rates; however, the outcomes of SAH management are dependent on many other factors. In this study, we used nationwide, large-scale, observational data to investigate short- and long-term mortality rates after SAH treatment and the influence of patient severity and hospital volume.

Patients and methods: We selected patients with SAH treated with clipping and coiling from the South Korean Acute Stroke Assessment Registry. High- and low-volume hospitals performed ≥20 clipping and coiling procedures and <20 clipping and coiling procedures per year, respectively. Short- and long-term mortality were tracked using data from the Health Insurance Review and Assessment Service.

Results: Among 2,634 patients treated using clipping and coiling, 1,544 (58.6%) and 1,090 (41.4%) were hospitalized in high- and low-volume hospitals, respectively, and 910 (34.5%) and 1,724 (65.5%) were treated with clipping and coiling, respectively. Mortality rates were 13.5, 14.4, 15.2, and 16.1% at 3 months, 1, 2, and 4 years, respectively. High-volume hospitals had a significantly lower 3-month mortality rate. Patients with mild clinical status had a significantly lower 3-month mortality rate in high-volume hospitals than in low-volume hospitals. Patients with severe clinical status had significantly lower 1- and 2-year mortality rates in high-volume hospitals than in low-volume hospitals.

Conclusion: Short- and long-term mortality in patients with SAH differed according to hospital volume. In the modern endovascular era, clipping and coiling can lead to better outcomes in facilities with high stroke-care capabilities.

Keywords: hospital volume; long-term outcomes; mortality; short-term outcomes; subarachnoid hemorrhage.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study population and patients with subarachnoid hemorrhage according to hospital volume.
Figure 2
Figure 2
The Kaplan–Meier estimate for survival probability of 2,634 patients with subarachnoid hemorrhage (SAH) treated with clipping and coiling. (A) According to age, (B) according to sex, (C) according to severity, and (D) according to clipping and coiling group.
Figure 3
Figure 3
Kaplan–Meier estimate for survival probability of 2,634 patients with subarachnoid hemorrhage (SAH) treated with clipping and coiling. (A) According to hospital type, (B) 910 patients treated with clipping according to hospital type, (C) 1,724 patients treated with coiling according to hospital type, (D) Mild patients according to hospital type, and (E) Severe patients according to hospital type.
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References

    1. Kim JY, Kang K, Kang J, Koo J, Kim DH, Kim BJ, et al. . Executive summary of stroke statistics in Korea 2018: a report from the epidemiology research council of the Korean stroke society. J Stroke. (2019) 21:42–59. 10.5853/jos.2018.03125 - DOI - PMC - PubMed
    1. Pobereskin LH. Incidence and outcome of subarachnoid haemorrhage: a retrospective population based study. J Neurol Neurosurg Psychiatry. (2001) 70:340–3. 10.1136/jnnp.70.3.340 - DOI - PMC - PubMed
    1. Chan V, O'Kelly C. Response by Chan and O'Kelly to letter regarding article. Declining admission and mortality rates for subarachnoid hemorrhage in Canada between 2004 and 2015. Stroke. (2019) 50:e133. 10.1161/STROKEAHA.119.025114 - DOI - PubMed
    1. Suarez JI, Zaidat OO, Suri MF, Feen ES, Lynch G, Hickman J, et al. . Length of stay and mortality in neurocritically ill patients: impact of a specialized neurocritical care team. Crit Care Med. (2004) 32:2311–7. 10.1097/01.CCM.0000146132.29042.4C - DOI - PubMed
    1. Bogason ET, Anderson B, Brandmeir NJ, Church EW, Cooke J, Davies GM, et al. . The epidemiology of admissions of nontraumatic subarachnoid hemorrhage in the United States. Neurosurgery. (2014) 74:227–9. 10.1227/NEU.0000000000000240 - DOI - PubMed

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