دورية أكاديمية
أعرض في EDS

Trends in Incidence and Mortality by Hospital Teaching Status and Location in Aneurysmal Subarachnoid Hemorrhage.

التفاصيل البيبلوغرافية
العنوان: Trends in Incidence and Mortality by Hospital Teaching Status and Location in Aneurysmal Subarachnoid Hemorrhage.
المؤلفون: Neifert SN; Department of Neurosurgery, Mount Sinai Hospital, New York, New York., Martini ML; Department of Neurosurgery, Mount Sinai Hospital, New York, New York., Hardigan T; Department of Neurosurgery, Mount Sinai Hospital, New York, New York., Ladner TR; Department of Neurosurgery, Mount Sinai Hospital, New York, New York., MacDonald RL; Department of Neurological Surgery, UCSF, Fresno, California, USA., Oermann EK; Department of Neurosurgery, Mount Sinai Hospital, New York, New York. Electronic address: eric.oermann@mountsinai.org.
المصدر: World neurosurgery [World Neurosurg] 2020 Oct; Vol. 142, pp. e253-e259. Date of Electronic Publication: 2020 Jun 27.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York : Elsevier
مواضيع طبية MeSH: Aneurysm, Ruptured/*epidemiology , Hospitals, Rural/*statistics & numerical data , Hospitals, Teaching/*statistics & numerical data , Hospitals, Urban/*statistics & numerical data , Intracranial Aneurysm/*epidemiology , Subarachnoid Hemorrhage/*epidemiology, Aged ; Aneurysm, Ruptured/mortality ; Female ; Hospital Bed Capacity ; Humans ; Hypertension ; Incidence ; Intracranial Aneurysm/mortality ; Male ; Middle Aged ; Mortality ; Multivariate Analysis ; Subarachnoid Hemorrhage/mortality ; United States/epidemiology
مستخلص: Objectives: Few studies have examined the impact of teaching status and location on outcomes in subarachnoid hemorrhage (SAH). The objective of the present study was to compare mortality and functional outcomes among urban teaching, urban nonteaching, and rural centers for hospitalizations with SAH.
Methods: The National Inpatient Sample for years 2003-2016 was queried for hospitalizations with aneurysmal SAH from 2003 to 2017. Cohorts treated at urban teaching, urban nonteaching, and rural centers were compared with the urban teaching center cohort acting as the reference. The National Inpatient Sample Subarachnoid Hemorrhage Outcome Measure, a validated measure of SAH functional outcome, was used as a coprimary outcome with mortality. Multivariable models adjusted for age, sex, NIH-SSS score, hypertension, and hospital bed size. Trends in SAH mortality rates were calculated.
Results: There were 379,716 SAH hospitalizations at urban teaching centers, 105,638 at urban nonteaching centers, and 17,165 at rural centers. Adjusted mortality rates for urban teaching centers were lower than urban nonteaching (21.90% vs. 25.00%, P < 0.0001) and rural (21.90% vs. 30.90%, P < 0.0001) centers. While urban teaching (24.74% to 21.22%) and urban nonteaching (24.78% to 23.68%) had decreases in mortality rates over the study period, rural hospitals showed increased mortality rates (25.67% to 33.38%).
Conclusions: Rural and urban nonteaching centers have higher rates of mortality from SAH than urban teaching centers. Further study is necessary to understand drivers of these differences.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Mortality; Rural; Subarachnoid hemorrhage; Teaching hospital; Urban
تواريخ الأحداث: Date Created: 20200630 Date Completed: 20210330 Latest Revision: 20210330
رمز التحديث: 20231215
DOI: 10.1016/j.wneu.2020.06.180
PMID: 32599190
قاعدة البيانات: MEDLINE
الوصف
تدمد:1878-8769
DOI:10.1016/j.wneu.2020.06.180