Abstract WP120: Readmission Trends Related to Unruptured Intracranial Aneurysm Treatment

Abstract

Introduction: The treatment of choice for Unruptured intracranial aneurysms (UICA) is dependent on assessment of several factors including aneurysm size, location, and morphology, along with patient's life expectancy and comorbid conditions. Although multiple studies have deliberated upon the efficacy of surgical and endovascular aneurysm treatment for UICA, the rate of readmission with either technique has not been specifically studied. Methods: We used the Nationwide Readmission database to assess the readmission trends related to various treatment approaches for UICA. The treatment approaches were subdivided into four groups; surgical clipping group and three endovascular approach groups (coil embolization, stent assisted coil embolization and only stent placement groups). All four groups were compared for the characteristics of index hospitalizations and top causes of readmissions. Results: We identified 3533 patients treated with clipping and 4134 (3865 coil embolization, 192 only stent placement and 76 stent assisted coil embolization) patients treated with endovascular approach. Thirty day readmission rate (30RR) was significantly higher with surgical clipping compared to the three endovascular approach groups (8.37% Vs 4.77%, p<0.01). Lower rates of home discharge disposition were observed during index hospitalization (73.8% Vs. 91.4%, p<0.01) and during readmission (53.3% Vs. 72.56%, p<0.01) amongst the clipping group compared to the endovascular groups. Major causes of readmission amongst clipping groups included intracranial hemorrhage (12.9%) and post operative infections (10.5%), Major causes of readmission amongst endovascular group included ischemic cerebrovascular event (21.3%) and headaches (8.6%). Conclusion: Patients undergoing endovascular treatment for UICA are less likely to be readmitted and more likely to be discharged home compared to surgical clipping. Given the complex decision making with consideration of anatomic and patient factors for UICA treatment, these findings do not necessarily prove the general superiority of the endovascular approach but do suggest that when a UICA can be safely treated with either technique, the endovascular approach might reduce the chances of readmission.