Women had lower odds of good clinical outcome (RR 0.83; 95% CI 0.74-0.94), while Black and Hispanic patients had lower mortality risk compared with White patients.
Observational (n=161,086)
Yes
Do sex and race/ethnicity impact clinical outcomes and in-hospital mortality in patients with aneurysmal subarachnoid hemorrhage?
In a large US cohort of aneurysmal subarachnoid hemorrhage, women had worse clinical outcomes, while Black and Hispanic patients had lower in-hospital mortality compared to White patients.
Effect estimate: RR 0.83 (95% CI 0.74-0.94)
p-value: p=0.004
Background: Aneurysmal subarachnoid hemorrhage is associated with high rate of morbidity and mortality. We aimed to assess prognostic impact of sex, race, and ethnicity in these patients. Methods: Nationwide Inpatient Sample (2000–2019) was used to identify patients presenting with aneurysmal subarachnoid hemorrhage as primary diagnosis. Patient age, sex, race/ethnicity, insurance status, socioeconomic status, comorbidities, type of the hospital, and treatment modality used for aneurysm repair were extracted. The previously validated Nationwide Inpatient Sample Subarachnoid Hemorrhage Severity Scale was used to estimate the clinical severity. Discharge destination and in-hospital mortality was used as outcome measured. The impact of race/ethnicity and sex on clinical outcome was analyzed using multivariate regression models. Results: A total of 161 086 patients with aneurysmal subarachnoid hemorrhage were identified. Mean age was 55.0±13.8 years. Sixty-nine percent of the patients were female, 60% White patients, and 17% Black patients. There was no difference in the Nationwide Inpatient Sample Subarachnoid Hemorrhage Severity Scale score between the 2 sexes. Women had significantly lower odds of good clinical outcome (defined as discharge to home or acute rehabilitation facility; RR, 0.83 95% CI, 0.74–0.94; P =0.004). Hispanic patients (RR, 1.12 95% CI, 1.07–1.17; P <0.001) had higher odds of excellent clinical outcome compared with White patients, and lower risk of mortality were observed in Black patients (RR, 0.73 95% CI, 0.66–0.81) and Hispanic patients (RR, 0.78 95% CI, 0.70–0.86) compared with the White patients. Conclusions: In this nationally representative study, women were less likely to have excellent outcomes following aneurysmal subarachnoid hemorrhage, and White patients had disproportionately higher likelihood of worse clinical outcomes. Lower rates of mortality were seen among Black and Hispanic patients.
Schüpper et al. (Mon,) conducted a observational in Aneurysmal subarachnoid hemorrhage (n=161,086). Female sex, Black race, and Hispanic ethnicity vs. Male sex and White race was evaluated on Good clinical outcome (discharge to home or acute rehabilitation facility) (RR 0.83, 95% CI 0.74-0.94, p=0.004). Women had lower odds of good clinical outcome (RR 0.83; 95% CI 0.74-0.94), while Black and Hispanic patients had lower mortality risk compared with White patients.