Intra Hospital Delay Increases Mortality and Poor Outcome in Endovascular Coiling of Ruptured Intracranial Aneurysms - Abstract
Background: The purpose of the study was to investigate the effects of intra hospital delay and time of admission on mortality and neurological outcome in endovascular coiling of ruptured intracranial aneurysms.
Methods: A retrospective analysis of a database comprising all consecutive cases of proven ruptured intracranial aneurysms admitted to the Neurocenter at Odense University Hospital was performed. All aneurysms admitted in a period of 5 years and 3 months were investigated for inclusion in. Mortality was measured as death at 180 days.
Results: 237 patients were included in the study. In 82,7% of patients, the procedure of endovascular coiling was started before 24 hours, in 17.3% beyond 24 hours. Mortality at six months was 15.3% in the <24H group vs. 39.0% in the ? 24H group, p<0, 0001. Increasing age was a significant predictor of delayed coiling
(OR=1.046, p=0.002).
Patients admitted during non-office time had 180 days mortality of 14.3% compared to 30.3 % in patients admitted during office hours, p= 0.004 .
Conclusions: The presence of intra hospital delay was confirmed. Delayed endovascular coiling of ruptured intracranial aneurysms increased mortality and poor neurological outcome significantly. High age was a predictor of delayed treatment. The survival and outcome was improved when the patients arrived during non-office time.