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Neuroepidemiology. 2014;42(2):90-7. doi: 10.1159/000355843. Epub 2013 Dec 3.

Treatment of aneurysmal subarachnoid haemorrhage in Germany: a nationwide analysis of the years 2005-2009.

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1
Institut für Klinische Epidemiologie, Medizinische Fakultät, Halle, Germany.

Abstract

BACKGROUND:

The aim of this study was to provide population-based nationwide rates of the different treatment modalities of aneurysmal subarachnoid haemorrhage (aSAH).

METHODS:

German Diagnosis-Related Group data of the years 2005-2009 were used to calculate hospitalisation rates for intracranial aneurysm with aSAH. This study includes over 83 million hospitalisations.

RESULTS:

We identified 15,768 hospitalisations with a diagnosis of aSAH. Throughout the observation period, the age-standardised rate for both sexes increased by 69% (95% confidence interval, CI 54-84) for coiling and 13% (95% CI 4-23) for clipping. The estimated annual percent change in the overall hospitalisation rate was 7.4% (95% CI 5.2-9.6). Age-standardised hospitalisation rates varied considerably by region. The estimated hospitalisation rate ratio of overall hospitalisation rates (East/West) was 0.86 (95% CI 0.80-0.91) for males and 0.81 (95% CI 0.77-0.85) for females. After adjustment for age and co-morbidity, the hazard ratio (HR) for in-hospital mortality was higher for coiling than clipping (HR = 1.12, 95% CI 1.01-1.23). Patients who received coiling or clipping had ventricular shunt placement in 5.0 (n = 819) and 6.1% (n = 998), respectively. The estimated length of stay was 3.3 days (95% CI 2.56-4.05) shorter for coiling than clipping.

CONCLUSIONS:

We provide for the first time nationwide, representative hospitalisation rates for the treatment of aSAH. Our results indicate a change in the practice pattern for Germany during the observation period. We observed a gradual increase in overall hospitalisation rates for aSAH.

PMID:
24334973
DOI:
10.1159/000355843
[Indexed for MEDLINE]

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