Surgical and endovascular treatment of unruptured cerebral aneurysms at university hospitals

摘要: Objective: To compare complications of surgical clipping and coil embolization in the treatment unruptured aneurysms. Background: Surgical has been preferred for cerebral aneurysms but endovascular is an increasingly employed alternative. No direct comparisons techniques are available to guide clinical decision making. Methods: We performed a cohort study patients treated at 60 university hospitals from January 1994 through June 1997 using University HealthSystem Consortium database. The database was validated by chart review one participant universities. main outcome measures were in-hospital mortality adverse outcomes, defined as deaths discharges nursing homes or rehabilitation hospitals. Results: primary modality 2,357 cases 255 cases. Adverse outcomes significantly more common (18.5%) compared (10.6%) ( p = 0.002), difference not altered after adjusting age, sex, race, transfer admissions, emergency room year (odds ratio [OR] 2.1, 95% confidence interval [CI] 1.4 3.3; 0.001). In-hospital also increased (2.3% versus 0.4%; 0.039), significant multivariable model (OR 6.3, CI 0.9 46.1; 0.07). Length stay hospital charges greater Conclusion: Endovascular resulted fewer than surgery studied. Although these results should be seen preliminary, magnitude current predominance appear justify randomized trial.