Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage

Neurosurgery
Chia-Hung ChouMichael J Alexander

Abstract

To assess the impact of vasospasm on costs, length of stay, and mortality among inpatients with aneurysmal subarachnoid hemorrhage. We combined hospital accounting and physician billing data for a consecutive cohort of 198 patients who underwent surgical clipping or endovascular coiling for subarachnoid hemorrhage repair. We considered patients with transcranial Doppler (TCD) velocity of 120 cm/s or greater in the middle cerebral artery to have TCD-defined vasospasm and patients with delayed ischemic neurological deficit to have symptomatic vasospasm. We compared outcomes of patients with TCD-defined vasospasm (n = 116) and those without (n = 73) and patients with symptomatic vasospasm (n = 62) and those without (n = 127), adjusting for demographic and clinical characteristics. In adjusted analyses, the incremental cost attributable to TCD-defined vasospasm was 1.20 times higher (95% confidence interval, 1.06-1.36; P = .004) than for patients without TCD-defined vasospasm. Length of stay was an estimated 1.22 times longer for patients with TCD-defined vasospasm (95% CI, 1.07-1.39; P < .01). For symptomatic vasospasm, adjusted costs were 1.27 times higher (95% CI, 1.12-1.43; P < .001) and length of stay was an estimated 1.24 tim...Continue Reading

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Citations

Jul 27, 2012·Therapeutic Delivery·Robert Loch MacdonaldTom Tice
Dec 11, 2013·Nature Reviews. Neurology·R Loch Macdonald
Aug 3, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Nicole M Dubosh, Jonathan A Edlow
Feb 14, 2012·Stroke; a Journal of Cerebral Circulation·R Loch MacdonaldStephan A Mayer
Mar 14, 2019·Translational Stroke Research·Syed M AdilShivanand P Lad

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