{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:38:56Z","timestamp":1792647536401,"version":"4.5.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Nontraumatic subarachnoid hemorrhage (SAH) carries a substantial mortality burden and risk of long\u2010term morbidity. Although prior investigations have demonstrated an inverse association between SAH admission volume and in\u2010hospital mortality, reported thresholds remain broad. Importantly, the relative importance of both admission and procedural volume has yet to be evaluated on a national scale. We examined the association of volume metrics with outcomes in an SAH cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">All adult (\u226518\u2009years) hospitalizations with a primary diagnosis of nontraumatic SAH were identified from the 2016 to 2022 Nationwide Readmissions Database. Multivariable regression models were developed to evaluate the independent and joint associations of SAH admission and clipping and coiling procedural volume with in\u2010hospital outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of an estimated 142\u2009271 hospitalizations, index mortality was 20.2%. Following risk adjustment, both increasing SAH admission volume and clipping and coiling procedural volume were independently associated with reduced mortality. When modeled jointly, however, clipping and coiling procedural volume remained an independent predictor of mortality (adjusted odds ratio, 0.981 per 10 procedures,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) whereas SAH admission volume was no longer significant (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.40).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Joint examination of SAH and clipping and coiling procedural volume revealed procedural caseload to be the dominant predictor of in\u2010hospital mortality, suggesting that survival benefits historically attributed to admission volume may be more precisely explained by procedural expertise. These findings support reexamination of volume\u2010based benchmarks in contemporary cerebrovascular care frameworks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050933","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:28:06Z","timestamp":1792150086000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary Analysis of the Volume\u2013Outcome Relationship for Patients With Nontraumatic Subarachnoid Hemorrhage"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6513-6907","authenticated-orcid":false,"given":"Owen","family":"Lai","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3087-4573","authenticated-orcid":false,"given":"Jaden","family":"Rahmani","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0832-4515","authenticated-orcid":false,"given":"Preston","family":"Leung","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konmal","family":"Ali","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed S.","family":"Ali","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3423-3825","authenticated-orcid":false,"given":"Won","family":"Kim","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-0933","authenticated-orcid":false,"given":"Geoffrey P.","family":"Colby","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4705-0262","authenticated-orcid":false,"given":"Peyman","family":"Benharash","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]},{"name":"David Geffen School of Medicine at UCLA","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019328"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.4346"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213353"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60153-6"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000436"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.117.007378"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70087-9"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa012337"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa035205"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000375"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000850"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018373"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0000000000000475"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.4407"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.9.JNS13640"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.JNS192584"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2001.94.3.0417"},{"key":"e_1_3_1_19_2","unstructured":"Agency for Healthcare Research and Quality . 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