The Effect of July Admission on Inpatient Morbidity, Mortality, and Discharge Disposition After Endovascular Coiling in Subarachnoid Hemorrhage

Objective To investigate effect of July admission on short-term outcome after endovascular coiling of patients with subarachnoid hemorrhage (SAH) owing to ruptured aneurysms. Methods Data from the National Inpatient Sample (2012–2014) were gathered. Adult patients with SAH who underwent endovascular therapy at a teaching hospital were identified. Admissions during July were compared with other months as well as based on admission quarter (AQ): AQ1 (July to September), AQ2 (October to December), AQ3 (January to March), and AQ4 (April to June). Outcome measures included inpatient morbidity (death, iatrogenic stroke, or myocardial infarction), inpatient mortality, and nonroutine discharges. Results The National Inpatient Sample database yielded 8515 patients with a diagnosis of SAH who underwent endovascular coiling between 2012 and 2014. Among these, 665 (7.8%) were admitted in July, and 7850 (92.2%) were admitted in other months. Overall, there were no differences in any of the examined outcomes, including morbidity (15.0% vs. 17.3%, P = 0.513), mortality (10.5% vs. 11.8%, P = 0.665), or nonroutine discharge (57.1% vs. 59.7%, P = 0.567), for patients admitted in July versus other months. Based on AQ, 24.5% of patients were admitted in AQ1, 26.0% in AQ2, 23.8% in AQ3, and 25.7% in AQ4. Similar to July versus other month admissions, there were no significant differences in outcomes based on AQ. Conclusions Based on findings of this national investigation, patients with SAH owing to ruptured aneurysms who undergo endovascular therapy during the beginning of the academic year in July may not have worse short-term outcome compared with patients with admissions during other months.