{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T05:23:32Z","timestamp":1732685012994,"version":"3.28.2"},"reference-count":25,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>COVID-19 had massive effects on the healthcare system and multifactorial implications for the management of intensive care unit and cerebrovascular patients. This study aimed to assess the effect of COVID-19 on the outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The National Inpatient Sample (NIS) was used to identify patients with nontraumatic SAH (ICD-10 code I60.x). Patients with nonaneurysmal cerebrovascular malformations or traumatic intracranial injuries were excluded. Only patients managed from April to December 2020 were included in the study given the availability of an ICD-10 code for COVID-19. Data on sociodemographic factors, hospital characteristics, comorbidities, NIS SAH Severity Score (NIS-SSS), surgical treatment, and death were acquired. Multivariable analysis was used to assess predictors of both surgical intervention and in-hospital mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In total, 6984 patients met the study criteria, 359 (5.1%) of whom had COVID-19. Those with COVID-19 were more likely to be younger and male and had a higher All Patient Refined Diagnosis-Related Groups illness severity subclass, and NIS-SSS. Moreover, patients with COVID-19 were less likely to undergo surgery (10.0% vs 23.6%, OR 0.35, p &lt; 0.0001) and had significantly higher mortality rates (48.2% vs 22.7%, p &lt; 0.0001). When controlling for other variables, COVID-19 was an independent predictor of death (OR 1.67, p = 0.0002). Aneurysm surgery was performed in 1597 patients (317 open and 1280 endovascular procedures). There was no difference between the cohorts positive and negative for COVID-19 in terms of time to surgery or type of surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>COVID-19 had significant impacts on patients with nontraumatic SAH. Specifically, patients with COVID-19 were significantly less likely to undergo surgery and had higher in-hospital mortality rates; however, for patients who did undergo procedural intervention, there was no significant difference in the type of intervention. Multiple factors, from medical acuity to healthcare system limitations, may contribute to these findings. Further retrospective research is needed to identify both specific causes of lower intervention rates and other potential nonaneurysmal causes of SAH in patients with COVID-19.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.1.jns231734","type":"journal-article","created":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:41:03Z","timestamp":1712364063000},"page":"833-843","source":"Crossref","is-referenced-by-count":0,"title":["Rates of operative intervention and in-hospital mortality following subarachnoid hemorrhage in patients with COVID-19"],"prefix":"10.3171","volume":"141","author":[{"given":"Jonathan","family":"Dallas","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Fixman","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of the University of Southern California, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ding","sequence":"additional","affiliation":[{"name":"Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Lin","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent N.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank J.","family":"Attenello","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William J.","family":"Mack","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Neurosurgery","first-page":"217","article-title":"The epidemiology of admissions of nontraumatic subarachnoid hemorrhage in the United States","volume":"73","author":"Rincon F","year":"2013","unstructured":"Rincon F, Rossenwasser RH, Dumont A. The epidemiology of admissions of nontraumatic subarachnoid hemorrhage in the United States. Neurosurgery. 2013;73(2):217\u2013222.212-213."},{"issue":"3","key":"b2","series-title":"N Engl J Med","first-page":"257","article-title":"Subarachnoid hemorrhage","volume":"377","author":"Lawton MT","year":"2017","unstructured":"Lawton MT, Vates GE. Subarachnoid hemorrhage. N Engl J Med. 2017;377(3):257\u2013266."},{"issue":"5","key":"b3","series-title":"JAMA Neurol","first-page":"588","article-title":"Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis","volume":"76","author":"Etminan N","year":"2019","unstructured":"Etminan N, Chang HS, Hackenberg K,  Worldwide incidence of aneurysmal subarachnoid hemorrhage according to region, time period, blood pressure, and smoking prevalence in the population: a systematic review and meta-analysis. 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