Introduction: The treatment of intracranial aneurysms has evolved significantly over the last 10-15 years. The Washington State Department of Health maintains the Comprehensive Hospital Abstract Reporting System (CHARS) data that captures all inpatient discharge information including demographics, billing charges, and ICD codes for diagnosis and procedures.
Methods: The CHARS data was queried from 2002-2014. Patients with ICD-9 codes matching aneurysmal subarachnoid hemorrhage (430) and unruptured intracranial aneurysms (473.3) were selected for inclusion in the analysis. The number of ruptured vs unruptured aneurysms discharges were compared for each calendar year as well as the associated hospital charges and length of stay.
Results: The number hospitalizations for intracranial aneurysms grew at 5.3% per year, outpacing population increase at 1.2% per year(p<0.05). This is primarily driven by unruptured intracranial aneurysms which grew at 11.2% per year(p<0.05). The average charge per hospitalization for both increased at approximately 10% per year, outpacing inflation at 2.2% per year(p<0.05). The average length of stay for ruptured intracranial aneurysms is significantly higher than for unruptured(12.2vs4.6 days, p<0.05).
Conclusions: Between 2002-2014, the number of hospitalizations for unruptured intracranial aneurysms increased 3.4-fold. The real impact of this is unclear and long-term observation is needed to demonstrate any decrease in incidence of aneurysmal SAH.
Patient Care: It helps clinicians gain greater awareness from a population standpoint in terms of the differing treatment patterns between ruptured vs unruptured aneurysms, with a tendency towards treating more unruptured cases. This may prompt a critical evaluation in terms of decision making regarding when unruptured aneurysms should be treated.
Learning Objectives: -Understand the shifting landscape of intracranial aneurysm over the last one and a half decade
-Be aware of resource utilization for treatment of intracranial aneurysms with possible over-utilization for unruptured ones