Your browser doesn't support javascript.
loading
Impact of neurovascular comorbidities and complications on outcomes after procedural management of arteriovenous malformations.
Thomas, Harrison C; Chotai, Silky; Patel, Pious D; Liles, Campbell; Chen, Heidi; Shannon, Chevis N; Froehler, Michael; Fusco, Matthew R; Chitale, Rohan V.
Afiliación
  • Thomas HC; Vanderbilt University School of Medicine, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Chotai S; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Patel PD; Vanderbilt University School of Medicine, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Liles C; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Chen H; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA; Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
  • Shannon CN; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Froehler M; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Fusco MR; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA.
  • Chitale RV; Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital, Vanderbilt, Nashville, TN, USA. Electronic address: rohan.chitale@vumc.org.
Clin Neurol Neurosurg ; 220: 107349, 2022 09.
Article en En | MEDLINE | ID: mdl-35785660
OBJECTIVE: Cerebral arteriovenous malformations (AVMs) are complex vascular lesions at perpetual risk for rupture, which can lead to significant morbidity and mortality. This study sought to evaluate the dynamic relationship between comorbidities and post-procedure complications to quantify the risk of poor discharge outcomes to create a predictive outcomes model. METHODS: The National Inpatient Sample (NIS) data from 2012 to 2015 was queried for AVM treatment using International Classification of Diseases, Ninth Revision codes. The Neurovascular Comorbidities Index (NCI) quantified patient comorbidity burden. In-hospital complications included surgical and medical complications or seizures. The primary outcome was the NIS Subarachnoid Hemorrhage Outcome Measure (NIS-SOM). RESULTS: A total of 1363 patients were included. A total of 1330 patients (98%) underwent embolization, 28 (2%) underwent resection, and 9 (0.7%) underwent radiosurgery. A higher NCI was associated with the occurrence of any complication (odds ratio [OR], 1.30 if NCI = 2; P < 0.001). Higher NCI was also significantly associated with a poor NIS-SOM outcome (OR, 2.45 if NCI = 2 and no complications; P < 0.001). A ruptured AVM with intracranial hemorrhage (ICH) increased the risk of in-hospital complications (OR, 2.16; P = 0.007) and a poor NIS-SOM outcome (OR, 3.18; P < 0.001). Various hypothetical patient scenarios and the predicted outcomes are also presented. CONCLUSION: Neurovascular comorbidities have a significant impact on poor functional outcomes at discharge in patients with and without complications following procedural management of AVMs. At the time of initial patient assessment, risk stratification strategies should take into account neurovascular comorbidities and potential complications. Such an approach would ultimately optimize patient outcomes and increase the value of care provided.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Malformaciones Arteriovenosas Intracraneales / Radiocirugia / Embolización Terapéutica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neurol Neurosurg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hemorragia Subaracnoidea / Malformaciones Arteriovenosas Intracraneales / Radiocirugia / Embolización Terapéutica Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Clin Neurol Neurosurg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos