Impact of Weekend Presentation on Short-Term Outcomes and Choice of Clipping vs Coiling in Subarachnoid Hemorrhage

Aditya S. Pandey, D. Andrew Wilkinson, Joseph J. Gemmete, Neeraj Chaudhary, B. Gregory Thompson, James F. Burke

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

BACKGROUND: Presentation on a weekend is commonly associated with higher mortality and a decreased likelihood of receiving invasive procedures. OBJECTIVE: To determine whether weekend presentation influences mortality, discharge destination, or type of treatment received (clip vs coil) in subarachnoid hemorrhage (SAH). METHODS: We performed a serial cross-sectional retrospective study using the Nationwide Inpatient Sample. All adult discharges with a primary diagnosis of SAH (ICD-9-CM 435) from 2005 to 2010 were included, and records with trauma or arteriovenous malformation were excluded. Unadjusted and adjusted associations between weekend presentation and 3 outcomes (in-hospital mortality, discharge destination, and treatment with clip vs coil) were estimated using chi-square tests and multilevel logistic regression. RESULTS: A total of 46 093 admissions for nontraumatic SAH were included in the sample; 24.6% presented on a weekend, 68.9% on a weekday, and 6.5% had unknown day of presentation. Weekend admission was not a significant predictor of inpatient mortality (25.4% weekend vs 24.9% weekday; P =.44), or a combined poor outcome measure of mortality or discharge to long-term acute care or hospice (30.3% weekend vs 29.4% weekday; P =.23). Among those treated for aneurysm obliteration, the proportion of clipped vs coiled did not change with weekend vs weekday presentation (21.5% clipped with weekend presentation vs 21.6% weekday, P =.95; 21.5% coiled with weekend presentation vs 22.4% weekday, P =.19). CONCLUSION: Presentation with nontraumatic SAH on a weekend did not influence mortality, discharge destination, or type of treatment received (clip vs coil) compared with weekday presentation.

Original languageEnglish (US)
Pages (from-to)87-91
Number of pages5
JournalNeurosurgery
Volume81
Issue number1
DOIs
StatePublished - Jul 1 2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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