In-hospital mortality and poor outcome after surgical clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage using nationwide databases: a systematic review and meta-analysis

Fusao Ikawa, Nobuaki Michihata, Toshinori Matsushige, Masaru Abiko, Daizo Ishii, Jumpei Oshita, Takahito Okazaki, Shigeyuki Sakamoto, Ryota Kurogi, Koji Iihara, Kunihiro Nishimura, Akio Morita, Kiyohide Fushimi, Hideo Yasunaga, Kaoru Kurisu

Research output: Contribution to journalArticle

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Abstract

There has never been evidence for aneurysmal subarachnoid hemorrhage (aSAH) by endovascular coiling compared to surgical clipping with all grade. The present study and meta-analysis aimed to clarify the in-hospital mortality and poor outcome in the nationwide databases of patients with all grade aSAH between them. The outcome of modified Rankin scale (mRS) at discharge was investigated according to the comprehensive nationwide database in Japan. The propensity score-matched analysis was conducted among patients with aSAH in this database registered between 2010 and 2015. Meta-analysis of studies was conducted based on the nationwide databases published from 2007 to 2018. According to this propensity score-matched analysis, no significant association for poor outcome of mRS > 2 was shown between surgical clipping and endovascular coiling (47.7% vs 48.3%, p = 0.48). However, significantly lower in-hospital mortality was revealed after surgical clipping than endovascular coiling (7.1% vs 12.2%, p < 0.001). Meta-analysis of propensity score-matched analysis in the nationwide database showed no significant association for poor outcome at discharge between them (odds ratio [OR], 1.08; 95% confidence interval [CI], 0.93 to 1.26; p = 0.31). Meta-analysis of propensity score-matched analysis for in-hospital mortality was lower after surgical clipping than after endovascular coiling, however, without significant difference (OR, 0.74; 95% CI, 0.52 to 1.04; p = 0.08). Further prospective randomized controlled study with all grade aSAH should be necessary to validate the in-hospital mortality and poor outcome.

Original languageEnglish
JournalNeurosurgical Review
DOIs
Publication statusPublished - Jan 1 2019

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Subarachnoid Hemorrhage
Hospital Mortality
Propensity Score
Meta-Analysis
Databases
Odds Ratio
Confidence Intervals
Japan

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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In-hospital mortality and poor outcome after surgical clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage using nationwide databases : a systematic review and meta-analysis. / Ikawa, Fusao; Michihata, Nobuaki; Matsushige, Toshinori; Abiko, Masaru; Ishii, Daizo; Oshita, Jumpei; Okazaki, Takahito; Sakamoto, Shigeyuki; Kurogi, Ryota; Iihara, Koji; Nishimura, Kunihiro; Morita, Akio; Fushimi, Kiyohide; Yasunaga, Hideo; Kurisu, Kaoru.

In: Neurosurgical Review, 01.01.2019.

Research output: Contribution to journalArticle

Ikawa, F, Michihata, N, Matsushige, T, Abiko, M, Ishii, D, Oshita, J, Okazaki, T, Sakamoto, S, Kurogi, R, Iihara, K, Nishimura, K, Morita, A, Fushimi, K, Yasunaga, H & Kurisu, K 2019, 'In-hospital mortality and poor outcome after surgical clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage using nationwide databases: a systematic review and meta-analysis', Neurosurgical Review. https://doi.org/10.1007/s10143-019-01096-2
Ikawa, Fusao ; Michihata, Nobuaki ; Matsushige, Toshinori ; Abiko, Masaru ; Ishii, Daizo ; Oshita, Jumpei ; Okazaki, Takahito ; Sakamoto, Shigeyuki ; Kurogi, Ryota ; Iihara, Koji ; Nishimura, Kunihiro ; Morita, Akio ; Fushimi, Kiyohide ; Yasunaga, Hideo ; Kurisu, Kaoru. / In-hospital mortality and poor outcome after surgical clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage using nationwide databases : a systematic review and meta-analysis. In: Neurosurgical Review. 2019.
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AU - Ikawa, Fusao

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AU - Matsushige, Toshinori

AU - Abiko, Masaru

AU - Ishii, Daizo

AU - Oshita, Jumpei

AU - Okazaki, Takahito

AU - Sakamoto, Shigeyuki

AU - Kurogi, Ryota

AU - Iihara, Koji

AU - Nishimura, Kunihiro

AU - Morita, Akio

AU - Fushimi, Kiyohide

AU - Yasunaga, Hideo

AU - Kurisu, Kaoru

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