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Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage.

Publication ,  Journal Article
Chou, C-H; Reed, SD; Allsbrook, JS; Steele, JL; Schulman, KA; Alexander, MJ
Published in: Neurosurgery
August 2010

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.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

August 2010

Volume

67

Issue

2

Start / End Page

345 / 351

Location

United States

Related Subject Headings

  • Vasospasm, Intracranial
  • Ultrasonography, Doppler, Transcranial
  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Smoking
  • Risk Factors
  • Neurology & Neurosurgery
  • Male
  • Length of Stay
  • Hypertension
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Chou, C.-H., Reed, S. D., Allsbrook, J. S., Steele, J. L., Schulman, K. A., & Alexander, M. J. (2010). Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery, 67(2), 345–351. https://doi.org/10.1227/01.NEU.0000371980.08391.71
Chou, Chia-Hung, Shelby D. Reed, Jennifer S. Allsbrook, Janet L. Steele, Kevin A. Schulman, and Michael J. Alexander. “Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage.Neurosurgery 67, no. 2 (August 2010): 345–51. https://doi.org/10.1227/01.NEU.0000371980.08391.71.
Chou C-H, Reed SD, Allsbrook JS, Steele JL, Schulman KA, Alexander MJ. Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2010 Aug;67(2):345–51.
Chou, Chia-Hung, et al. “Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage.Neurosurgery, vol. 67, no. 2, Aug. 2010, pp. 345–51. Pubmed, doi:10.1227/01.NEU.0000371980.08391.71.
Chou C-H, Reed SD, Allsbrook JS, Steele JL, Schulman KA, Alexander MJ. Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2010 Aug;67(2):345–351.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

August 2010

Volume

67

Issue

2

Start / End Page

345 / 351

Location

United States

Related Subject Headings

  • Vasospasm, Intracranial
  • Ultrasonography, Doppler, Transcranial
  • Treatment Outcome
  • Subarachnoid Hemorrhage
  • Smoking
  • Risk Factors
  • Neurology & Neurosurgery
  • Male
  • Length of Stay
  • Hypertension