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E-200 Gender and racial disparity in outcome of aneurysmal subarachnoid hemorrhage in the united states
  1. S Majidi,
  2. A Mehta,
  3. B Yim,
  4. K Yaeger,
  5. R De Leacy,
  6. J Mocco,
  7. J Fifi
  1. Neurosurgery, Mount Sinai Hospital, New York, NY


Background Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high rate of morbidity and mortality. We aimed to assess the prognostic impact of gender and race in these patients.

Methods The Nationwide Inpatient Sample (NIS 2006–2016) was utilized to identify patients presenting with aSAH as primary diagnosis. Patient age, sex, race/ethnicity, insurance status, socioeconomic status, comorbidities, type of the hospital and treatment modality used for aneurysm repair were extracted. The previously validated NIS-SAH Severity Scale was used to estimate the clinical severity. Discharge destination and in-hospital mortality were used as outcome measures. The impact of race and gender on clinical outcome was analyzed using multivariate regression models.

Results A total of 19,512 patients with aSAH were identified. Mean age (±SD) was 54 (±0.1). Sixty seven percent of the patients were female, 49% white and 13% black. Female patients were 4 years older (55 vs 51, p<0.0001), and had higher numbers of comorbidities. There was no difference in the NIS-SAH Severity Scale score between the two genders. Women had significantly lower odds of good clinical outcome (defined as discharge to home or acute rehabilitation facility) after adjusting for confounding factors [OR, (95% CI); p-value: 0.88, (0.81–0.96); p<0.0001]. In regard to race, Hispanic patients [OR, (95% CI); p-value: 1.49, (1.29–1.72); p<0.0001] and Asians [OR, (95% CI); p-value: 1.33, (1.07–1.64); p<0.0001] had higher odds of good clinical outcome after adjusting for age, gender, SAH severity, comorbidities and treatment modality. Lower odds of mortality was observed in black [OR, (95% CI); p-value: 0.55, (0.46–0.66); p<0.0001] and Hispanic patients [OR, (95% CI); p-value: 0.72, (0.59–0.88); p=0.001] compared to the white patients.

Conclusions In this nationally representative study, women and white patients had disproportionately higher likelihood of poor clinical outcome. Lower rate of mortality is seen among black and Hispanics.

Disclosures S. Majidi: None. A. Mehta: None. B. Yim: None. K. Yaeger: None. R. De Leacy: None. J. Mocco: None. J. Fifi: None.

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