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A predictive model of outcomes during cerebral aneurysm coiling
- Source :
- Journal of neurointerventional surgery. 6(5)
- Publication Year :
- 2013
-
Abstract
- Background Benchmarking of complications is necessary in the context of the developing path to accountable care. We attempted to create a predictive model of negative outcomes in patients undergoing cerebral aneurysm coiling (CACo). Methods We performed a retrospective cohort study involving patients who underwent CACo from 2005 to 2009 and who were registered in the Nationwide Inpatient Sample database. A model for outcome prediction based on individual patient characteristics was developed. Results Of the 10 607 patients undergoing CACo, 6056 presented with unruptured aneurysms (57.1%) and 4551 with subarachnoid hemorrhage (42.9%). The respective inpatient postoperative risks were 0.3%, 5.7%, 1.8%, 0.8%, 0.5%, 0.2%, 1.9%, and 0.1% for unruptured aneurysms, and 13.8%, 52.8%, 4.9%, 36.7%, 1%, 2.9%, 2.3%, and 0.8% for ruptured aneurysms for death, unfavorable discharge, stroke, treated hydrocephalus, cardiac complications, deep vein thrombosis, pulmonary embolism, and acute renal failure. Multivariate analysis identified risk factors independently associated with the above outcomes. A validated model for outcome prediction based on individual patient characteristics was developed. The accuracy of the model was estimated by the area under the receiver operating characteristic curve, and it was found to have good discrimination. Conclusions The presented model can aid in the prediction of the incidence of postoperative complications, and can be used as an adjunct in tailoring the treatment of cerebral aneurysms.
- Subjects :
- Adult
Male
medicine.medical_specialty
Subarachnoid hemorrhage
Databases, Factual
Deep vein
Context (language use)
Aneurysm
Predictive Value of Tests
Risk Factors
medicine
Humans
Hospital Mortality
Stroke
Aged
Retrospective Studies
Heart Failure
Venous Thrombosis
Models, Statistical
business.industry
Incidence
Retrospective cohort study
Intracranial Aneurysm
General Medicine
Acute Kidney Injury
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Thrombosis
Embolization, Therapeutic
Pulmonary embolism
Surgery
medicine.anatomical_structure
Logistic Models
Outcome and Process Assessment, Health Care
Multivariate Analysis
Critical Pathways
Female
Neurology (clinical)
business
Pulmonary Embolism
Subjects
Details
- ISSN :
- 17598486
- Volume :
- 6
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of neurointerventional surgery
- Accession number :
- edsair.doi.dedup.....3f58ece7507048c0bc88779cfd0b5f0a