Journal article
In-hospital imaging utilization after elective endovascular brain aneurysm treatment: a surrogate metric for the value of hospitalization
Journal of neurosurgery, Vol.140(2), pp.430-435
02/01/2024
DOI: 10.3171/2023.5.JNS23656
Abstract
OBJECTIVE Despite the adoption of same-day outpatient surgical procedures in some specialties, it remains common practice to admit patients for monitoring after elective endovascular treatment of brain aneurysms to monitor for complications. The necessity of such monitoring has not been fully characterized. Here, the authors reviewed the utilization of imaging during posttreatment hospitalization, a surrogate measure for workup of suspected complications requiring hospital resources, to infer the value of inpatient monitoring after endovascular aneurysm treatment. METHODS Clinical and angiographic data from eligible patients were retrospectively assessed for demographic characteristics, imaging indications, timing of imaging, and imaging findings. Patients were included if they underwent elective endovascular brain aneurysm treatment, and patients were excluded if significant intraprocedural complications occurred. The recorded imaging modalities included CT, MRI, catheter-based imaging, and ultrasound; plain radiographs were excluded. Multivariable logistic regression analysis was performed to identify predictors of the need for posttreatment imaging. RESULTS In total, 1229 elective endovascular procedures for brain aneurysm treatment were included. Patients underwent imaging before discharge in 13.4% (165/1229) of cases, with significant findings in 5.0% (61/1229) of cases. The median (interquartile range) time to first posttreatment imaging was 13.2 (4.2–22.8) hours. The need for imaging during posttreatment hospitalization was positively associated with larger aneurysm size (p < 0.05) and negatively associated with underlying cardiovascular disease (p < 0.05). CONCLUSIONS More than 1 in 8 patients who underwent elective endovascular brain aneurysm treatment required imaging during posttreatment hospitalization, most within the first 24 hours, and 1 in 20 had significant findings. These results suggest the importance of short-term hospitalization after elective endovascular aneurysm treatment.
Details
- Title: Subtitle
- In-hospital imaging utilization after elective endovascular brain aneurysm treatment: a surrogate metric for the value of hospitalization
- Creators
- David C. Lauzier - Washington University in St. Louis School of MedicineSamuel J. Cler - Washington University in St. Louis School of MedicineArindam R. Chatterjee - Washington University in St. Louis School of MedicineJoshua W. Osbun - Washington University in St. LouisAnanth K. Vellimana - Washington University in St. Louis School of MedicineColin P. Derdeyn - University of IowaDewitte T. Cross - Washington University in St. Louis School of MedicineChristopher J. Moran - Washington University in St. Louis School of MedicineAkash P. Kansagra - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Journal of neurosurgery, Vol.140(2), pp.430-435
- DOI
- 10.3171/2023.5.JNS23656
- ISSN
- 0022-3085
- eISSN
- 1933-0693
- Language
- English
- Electronic publication date
- 07/28/2023
- Date published
- 02/01/2024
- Academic Unit
- Radiology; Neurology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984449722002771
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