A predictive model of outcomes during cerebral aneurysm coiling.
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.
['Bekelis|Kimon|K|', 'Missios|Symeon|S|', 'Mackenzie|Todd A|TA|', 'Fischer|Adina|A|', 'Labropoulos|Nicos|N|', 'Eskey|Clifford|C|']
D058186:Acute Kidney Injury D000328:Adult D000368:Aged D019091:Critical Pathways D016208:Databases, Factual D004621:Embolization, Therapeutic D005260:Female D006333:Heart Failure D017052:Hospital Mortality D006801:Humans D015994:Incidence D002532:Intracranial Aneurysm D016015:Logistic Models D008297:Male D008875:Middle Aged D015233:Models, Statistical D015999:Multivariate Analysis D010043:Outcome and Process Assessment, Health Care D011237:Predictive Value of Tests D011655:Pulmonary Embolism D012189:Retrospective Studies D012307:Risk Factors D013345:Subarachnoid Hemorrhage D020246:Venous Thrombosis
Aneurysm Coil Hemorrhage Intervention