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SNIS 21st annual meeting electronic poster abstracts
E-256 Impact of the covid-19 pandemic on treatment trends of aneurysmal subarachnoid hemorrhage
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  1. S Patel1,
  2. A Balabhadra2,
  3. I Gandhi3,
  4. F Otite4,
  5. M Jaffa5,
  6. C Bruno1,
  7. E Sussman6,
  8. M Ollenschleger1,
  9. M Alberts5,
  10. T Mehta1
  1. 1Department of Interventional Neuroradiology, Hartford Hospital, Hartford, CT
  2. 2Department of Neurology, University of Connecticut, Farmington, CT
  3. 3University of Connecticut, Storrs, CT
  4. 4Department of Neurology, University of Connecticut, Syracuse, NY
  5. 5Department of Neurology, Hartford Hospital, Hartford, CT
  6. 6Department of Neurosurgery, Hartford Hospital, Hartford, CT

Abstract

Background We explore COVID-19’s potential link to aneurysm evolution via hypercytokinemia and inflammation, analyzing its impact on ruptured aneurysmal subarachnoid hemorrhage (aSAH) trends and outcomes.

Methods We queried the 2016–2020 National Inpatient Sample (NIS) database for patients aged 18 years and above with aSAH. Patients were treated either surgically or endovascularly (EV) and were identified using ICD-10 codes. Using SAS software, we defined baseline demographics, hospital characteristics, and outcomes for two groups: pre-COVID (2016–2019) vs. COVID (2020). Weighted discharge data was used to generate national estimates.

Results We identified 55,340 patients admitted with aSAH who underwent treatment with either open surgical approach (n=14,445; 26.1%), EV approach (n=38,085; 68.8%) or combined (n=2,810; 5.1%). Median age was 56.4 years (surgical group 55.0 vs. EV group 56.7; P>0.05) with 37,550 (67.9%) being female. After adjusting for age and gender, there were no significant differences observed in inpatient mortality rates between the two treatment groups (surgical group- OR: 1.12; p=0.39 and EV group- OR:1.07; p=0.41) between pre-COVID vs. COVID epoch. During the COVID pandemic, 170 COVID+ patients underwent treatment (surgical group n=35/170 (20.6%) and EV group n=135/170 (79.4%)). Baseline characteristics between COVID+ vs. COVID- groups were age 48.5 vs. 56.4 (p=0.011), length of stay 19.0 vs. 15.5 (p=0.028), total hospital charges $503,872 vs. $341,657 (P=0.0008). The ratio of EV vs. open surgical approach was 2.6 from 2016–2020 for COVID-patients whereas a ratio of 4.7 was observed in COVID+ patients during 2020 (p=0.004).

Conclusion This nationwide study of the NIS demonstrated higher utilization of EV therapy compared to an open surgical approach among COVID+ patients. Higher total hospital charges were captured during the COVID pandemic without a significant mortality difference.

Abstract E-256 Figure 1
Abstract E-256 Figure 1

Disclosures S. Patel: None. A. Balabhadra: None. I. Gandhi: None. F. Otite: None. M. Jaffa: None. C. Bruno: None. E. Sussman: None. M. Ollenschleger: None. M. Alberts: None. T. Mehta: None.

https://doi.org/10.1136/jnis-2024-SNIS.361

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