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| Publications [#183846] of Shelby Reed
Papers Published
- CH Chou, SD Reed, JS Allsbrook, JL Steele, KA Schulman, MJ Alexander, Costs of vasospasm in patients with aneurysmal subarachnoid hemorrhage.,
Neurosurgery, vol. 67 no. 2
(August, 2010),
pp. 345-51; discussion 351-2, ISSN 1524-4040 [doi]
(last updated on 2013/07/01)
Abstract:
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. CONCLUSIONS: Patients with subarachnoid hemorrhage and TCD-defined or symptomatic vasospasm incur higher inpatient costs and longer hospital stays than those without vasospasm.
Keywords:
Adult • Blood Flow Velocity • Cohort Studies • Cost of Illness • Female • Hospital Mortality • Humans • Hypertension • Length of Stay • Male • Risk Factors • Smoking • Subarachnoid Hemorrhage • Treatment Outcome • Ultrasonography, Doppler, Transcranial • Vasospasm, Intracranial • adverse effects • complications • complications* • economics* • epidemiology • etiology* • mortality • physiology
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