Resource use after subarachnoid hemorrhage: comparison between endovascular and surgical treatment.
OBJECTIVE
The aim of this study was to compare resource use after endovascular treatment and surgical clipping of ruptured intracranial aneurysms.


METHODS
The study population consisted of patients with aneurysmal subarachnoid hemorrhage who were actively treated in Kuopio University Hospital. The baseline patients' characteristics were obtained from the institution's aneurysm registry. Variables indicating resource use in the intensive care unit (ICU) were obtained from the ICU patient data management system. The Therapeutic Intervention Scoring System was used to measure the intensity of treatment in the ICU. All care days in the ICU and in the hospital and all Therapeutic Intervention Scoring System points that were accumulated during the 12-month follow-up period were calculated. Outcomes were assessed according to the Glasgow Outcome Scale.


RESULTS
The study population consisted of 68 patients who underwent endovascular treatment and 103 patients who had surgery. The median lengths of stay in the ICU (1.7 versus 1.8 d) and the hospital (14.0 versus 15.0 d), as well as the accumulated Therapeutic Intervention Scoring System points (56 versus 55), among patients who underwent endovascular or surgical treatment were similar (P = NS for all). The modality of treatment did not influence the number of ICU or hospital patient days or the intensity of ICU treatment, regardless of the patient's preoperative clinical status.


CONCLUSIONS
The modality of treatment of patients with subarachnoid hemorrhage does not seem to affect resource use. Endovascular and surgical treatment are likely to require a similar amount of ICU resources in the year after initial treatment.
Niskanen
Minna
M
Department of Anesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland. minna.niskanen@kuh.fi
Koivisto
Timo
T
Ronkainen
Antti
A
Rinne
Jaakko
J
Ruokonen
Esko
E
D000328:Adult; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery*