Cargando…

Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012

BACKGROUND: The dilemma concerning the appropriate treatment of the intracranial aneurysms (IAs) has not yet been resolved and still remains under fierce debate. This study refers to the recent trends in the use of and outcomes related to coiling compared with clipping for unruptured and ruptured IA...

Descripción completa

Detalles Bibliográficos
Autores principales: Tykocki, Tomasz, Kostyra, Kacper, Czyż, Marcin, Kostkiewicz, Bogusław
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988525/
https://www.ncbi.nlm.nih.gov/pubmed/24499992
http://dx.doi.org/10.1007/s00701-014-2006-z
_version_ 1782312031772213248
author Tykocki, Tomasz
Kostyra, Kacper
Czyż, Marcin
Kostkiewicz, Bogusław
author_facet Tykocki, Tomasz
Kostyra, Kacper
Czyż, Marcin
Kostkiewicz, Bogusław
author_sort Tykocki, Tomasz
collection PubMed
description BACKGROUND: The dilemma concerning the appropriate treatment of the intracranial aneurysms (IAs) has not yet been resolved and still remains under fierce debate. This study refers to the recent trends in the use of and outcomes related to coiling compared with clipping for unruptured and ruptured IAs in Poland over a 4-year period. METHODS: The analysis refers to treatment of IAs performed in Poland between 2009-2012. Patients’ records were cross-matched by ICD-9 codes for ruptured SAH (430) or unruptured cerebral aneurysm (437.3) along with codes for clipping (39.51) and coiling (39.79, 39.72, or 39.52). Multivariable logistic regression was used to compare in-hospital deaths, hospital length of stay (LOS), therapy allocation and aneurysm locations in unruptured vs. ruptured and clipped vs. coiled groups. Differences in the number of procedures between 16 administrative regions were standardized per 100,000 people. RESULTS: In 2009-2012, 11,051 procedures were identified, including 5,968 ruptured and 5,083 unruptured aneurysms. Overall increase was 2.3 % in clipping and 13.1 % in coiling; a significant trend was found in endovascular procedures (p = 0.044). Ruptured aneurysms were clipped more frequently (OR = 1.66;); in unruptured IAs, endovascular procedure was preferred 3.5 times more than clipping. The annual in-hospital mortality was 7.6 % in clipping and 6.7 % in endovascular treatment. LOS was two times longer after clipping in unruptured aneurysms (OR = 2.013). After the procedures were standardized per 100,000 people, the average for Poland was established as 9.09 in 2009, 10.86 in 2010, 10.55 in 2011, and 11.49 in 2012. This index had the highest values in Mazovia (12.9, 2009; 15.4, 2010; 17.4, 2011; 18.6, 2012. CONCLUSIONS: Data analysis revealed an increase in overall number of IAs treated in Poland between 2009-2012. A significant upward trend of endovascular procedures was found, whereas the number of clipped aneurysms remained relatively steady over the study period.
format Online
Article
Text
id pubmed-3988525
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Springer Vienna
record_format MEDLINE/PubMed
spelling pubmed-39885252014-04-23 Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012 Tykocki, Tomasz Kostyra, Kacper Czyż, Marcin Kostkiewicz, Bogusław Acta Neurochir (Wien) Clinical Article - Vascular BACKGROUND: The dilemma concerning the appropriate treatment of the intracranial aneurysms (IAs) has not yet been resolved and still remains under fierce debate. This study refers to the recent trends in the use of and outcomes related to coiling compared with clipping for unruptured and ruptured IAs in Poland over a 4-year period. METHODS: The analysis refers to treatment of IAs performed in Poland between 2009-2012. Patients’ records were cross-matched by ICD-9 codes for ruptured SAH (430) or unruptured cerebral aneurysm (437.3) along with codes for clipping (39.51) and coiling (39.79, 39.72, or 39.52). Multivariable logistic regression was used to compare in-hospital deaths, hospital length of stay (LOS), therapy allocation and aneurysm locations in unruptured vs. ruptured and clipped vs. coiled groups. Differences in the number of procedures between 16 administrative regions were standardized per 100,000 people. RESULTS: In 2009-2012, 11,051 procedures were identified, including 5,968 ruptured and 5,083 unruptured aneurysms. Overall increase was 2.3 % in clipping and 13.1 % in coiling; a significant trend was found in endovascular procedures (p = 0.044). Ruptured aneurysms were clipped more frequently (OR = 1.66;); in unruptured IAs, endovascular procedure was preferred 3.5 times more than clipping. The annual in-hospital mortality was 7.6 % in clipping and 6.7 % in endovascular treatment. LOS was two times longer after clipping in unruptured aneurysms (OR = 2.013). After the procedures were standardized per 100,000 people, the average for Poland was established as 9.09 in 2009, 10.86 in 2010, 10.55 in 2011, and 11.49 in 2012. This index had the highest values in Mazovia (12.9, 2009; 15.4, 2010; 17.4, 2011; 18.6, 2012. CONCLUSIONS: Data analysis revealed an increase in overall number of IAs treated in Poland between 2009-2012. A significant upward trend of endovascular procedures was found, whereas the number of clipped aneurysms remained relatively steady over the study period. Springer Vienna 2014-02-06 2014 /pmc/articles/PMC3988525/ /pubmed/24499992 http://dx.doi.org/10.1007/s00701-014-2006-z Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Clinical Article - Vascular
Tykocki, Tomasz
Kostyra, Kacper
Czyż, Marcin
Kostkiewicz, Bogusław
Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title_full Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title_fullStr Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title_full_unstemmed Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title_short Four-year trends in the treatment of cerebral aneurysms in Poland in 2009-2012
title_sort four-year trends in the treatment of cerebral aneurysms in poland in 2009-2012
topic Clinical Article - Vascular
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3988525/
https://www.ncbi.nlm.nih.gov/pubmed/24499992
http://dx.doi.org/10.1007/s00701-014-2006-z
work_keys_str_mv AT tykockitomasz fouryeartrendsinthetreatmentofcerebralaneurysmsinpolandin20092012
AT kostyrakacper fouryeartrendsinthetreatmentofcerebralaneurysmsinpolandin20092012
AT czyzmarcin fouryeartrendsinthetreatmentofcerebralaneurysmsinpolandin20092012
AT kostkiewiczbogusław fouryeartrendsinthetreatmentofcerebralaneurysmsinpolandin20092012