Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage.

Published

Journal Article

OBJECTIVE: To assess the impact of vasospasm on costs, length of stay, and mortality among inpatients with aneurysmal subarachnoid hemorrhage. METHODS: 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. RESULTS: 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 times longer (95% CI, 1.09-1.40; P < .01) for patients with vasospasm than for those without. There was no significant relationship between either type of vasospasm and in-hospital mortality. CONCLUSION: Patients with subarachnoid hemorrhage and TCD-defined or symptomatic vasospasm incur higher inpatient costs and longer hospital stays than those without vasospasm.

Full Text

Duke Authors

Cited Authors

  • Chou, C-H; Reed, SD; Allsbrook, JS; Steele, JL; Schulman, KA; Alexander, MJ

Published Date

  • August 2010

Published In

Volume / Issue

  • 67 / 2

Start / End Page

  • 345 - 351

PubMed ID

  • 20644420

Pubmed Central ID

  • 20644420

Electronic International Standard Serial Number (EISSN)

  • 1524-4040

International Standard Serial Number (ISSN)

  • 0148-396X

Digital Object Identifier (DOI)

  • 10.1227/01.neu.0000371980.08391.71

Language

  • eng