Abstract WP209: Trends in Mortality, Length of Stay and Effect of Teaching Hospital Status in Subarachnoid Hemorrhage Patients in the United States From 2000-2014

Abstract

Background and Purpose: Subarachnoid Hemorrhage (SAH) is a significant cause of morbidity and mortality in the United States. Mortality and length of stay (LOS) are significant in cases of SAH. The primary objective of our study was to analyze the mortality rate, LOS associated with SAH hospital admissions from 2000 to 2014. We also analyzed if teaching status of the hospital has any effect on LOS and mortality. Methods: Nationwide inpatient sample (NIS) database was used to identify SAH admissions in all patients from 2000 to 2014 using ICD-9-CM code 430 as the principal discharge diagnosis. NIS is the largest all-payer inpatient care database in the United States, containing data on more than 7 million hospital stays. It has a large sample size which is ideal for developing national and regional estimates. Results: A total of 376,263 discharges with a diagnosis of SAH were analyzed from 2000 to 2014 from the NIS database. The number of hospitalizations increased from 24,993 in 2000 to 25,775 in 2014. In-hospital mortality decreased from 25.85% in 2000 to 18.86% in 2014 a decrease of 27.04% (P < 0.0001). Mean LOS has remained the same from 11.8 days to 12 days during the same period. Mortality rates and LOS in non-teaching hospitals was 30.26% and 9.2 days in 2000 and 28.71% and 6.9 days in 2014(P < 0.0001). Mortality rates and LOS in teaching hospitals was 23.3% and 13.2 days in 2000 and 18.28% and 12.5 days in 2014(P < 0.0001). Conclusion: Overall in-hospital mortality associated with SAH has decreased over the years. The decrease in mortality can be attributed to early diagnosis and early institution of aggressive treatments. LOS in teaching hospitals is considerably higher which can be attributed to the complex co-morbid cases admitted and transferred to teaching hospitals. Mortality from SAH in non-teaching hospitals is significantly higher. Further research needs to be done to find the disparities in mortality rates based on teaching status of the hospital.