{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T04:13:57Z","timestamp":1743135237405,"version":"3.40.3"},"reference-count":16,"publisher":"Korean Society of Cerebrovascular Surgeons\/Korean Society of Endovascular Surgery","issue":"1","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1G1A1010805"],"award-info":[{"award-number":["2022R1G1A1010805"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["the-jcen.org"],"crossmark-restriction":true},"short-container-title":["J Cerebrovasc Endovasc Neurosurg"],"published-print":{"date-parts":[[2025,3,31]]},"abstract":"<jats:p>Objective: In this study, changes in treatment methods and patient prognosis were analyzed using a Korean nationwide medical insurance information database.Methods: Patients with subarachnoid hemorrhage who received surgical treatment for cerebral aneurysm from 2005 to 2020 were included. The specific surgery type was classified using the surgical code and according to whether stents were used. Yearly trends in mortality rates and poor prognosis, using tracheostomy as proxy, were analyzed by a simple regression analysis. A multistep logistic regression analysis was performed to evaluate the risk factors of mortality and poor prognosis.Results: Overall, 83,587 patients were included. Females were predominant (64.5%). Microsurgical clip usage rate decreased by approximately two-thirds from 78.8% in 2005 to 24.4% in 2020. Contrarily, endovascular treatment proportion gradually increased, and stent-assisted coil embolization rate surpassed microsurgical clip usage rate in 2020 (24.6% vs. 24.4%). In the multivariate analysis, endovascular treatment correlated positively with 3-month mortality (hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 1.07\u20131.19, P&lt;0.0001), although correlated negatively with poor prognosis (tracheostomy) (HR: 0.93, 95% CI: 0.89\u20130.98, P=0.0050).Conclusions: According to the treatment trend analysis, during the 16 years studied, for patients with subarachnoid hemorrhage due to ruptured cerebral aneurysm, the endovascular treatment rate increased rapidly and stent-assisted coil embolization rate surpassed that of microsurgical clip ligation. Diversification of treatment methods has led to a decrease in mortality and improved prognosis.<\/jats:p>","DOI":"10.7461\/jcen.2024.e2024.08.005","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T01:12:22Z","timestamp":1732842742000},"page":"19-32","update-policy":"https:\/\/doi.org\/10.7461\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["National trends in surgical treatment and clinical outcomes among patients with aneurysmal subarachnoid hemorrhage in the Republic of Korea"],"prefix":"10.7461","volume":"27","author":[{"given":"Yung Ki","family":"Park","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byul-Hee","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eui-Hyun","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9179-8569","authenticated-orcid":true,"given":"Jae Hoon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee In","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu Deok","family":"Won","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Whan","family":"Cheong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4334","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.120.028798"},{"key":"ref2","first-page":"e314","volume-title":"2023 Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: A guideline from the American Heart Association\/American Stroke Association","author":"Hoh","year":"2023"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3171\/2016.12.jns161039"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp1605827"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-013799"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd003085.pub3"},{"key":"ref7","first-page":"1019","volume-title":"Outcome after clipping and coiling for aneurysmal subarachnoid hemorrhage in clinical practice in Europe, USA, and Australia","author":"Lindgren","year":"2019"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3171\/2019.4.jns19779"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)30668-7"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.a3642"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(05)67214-5"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(09)70126-7"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyaa465"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.117.019328"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-329200"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-022-01476-5"}],"container-title":["Journal of Cerebrovascular and Endovascular 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