Factors associated with 30-day readmission in patients treated for unruptured intracranial aneurysms: a systematic review and meta-analysis

IF 1.4 4区医学 Q4 CLINICAL NEUROLOGY

Neurochirurgie Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI:10.1016/j.neuchi.2026.101779

Leonardo Di Cosmo , Jad El Choueiri , Christopher Peter Imbrogno , Pedro Lucas Machado Magalhães , Andrea Cardia , Ismail Zaed

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引用次数: 0

Abstract

Background and objectives

Unplanned 30-day readmission after elective treatment of unruptured intracranial aneurysms (UCAs) represents a significant clinical and economic burden. Reported readmission rates vary significantly, and the predictors of early rehospitalization remain elusive. This meta-analysis evaluates the prevalence of 30-day unplanned readmission and identifies predictors associated with increased readmission risk.

Methods

Following PRISMA guidelines, databases were searched through October 2025, reporting 30-day unplanned readmission after microsurgical clipping or endovascular treatment of UCAs. Random-effects models were applied. Risk ratios (RR) were used for dichotomous variables, mean differences (MD) for continuous variables, and pooled prevalence estimates were produced using a generalized linear mixed model.

Results

Our analysis included 70,463 patients treated for UCAs across seven studies; 3,655 experienced a 30-day unplanned readmission. The prevalence of readmission was 4.8% (95% CI, 3.0–7.5%), and rates did not differ significantly between microsurgical and endovascular treatment (5.9% vs 3.4%; P = 0.26). Several comorbidities were significantly associated with increased readmission risk, including hypertension, hyperlipidemia, diabetes mellitus, and anticoagulant use. Length of index hospital stay was also associated with higher readmission risk. Age, sex, smoking status, and antiplatelet use were not significant predictors.

Conclusion

This meta-analysis identified a 4.8% prevalence of unplanned 30-day readmission following elective treatment of UCAs. These findings suggest the need for careful risk stratification and preoperative comorbidity management for patients undergoing UCA repair, particularly among those with cardiometabolic comorbidities and complicated index hospitalizations. Implementing these strategies in high-risk patients may help reduce preventable readmissions and improve healthcare resource utilization.

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未破裂颅内动脉瘤患者30天再入院相关因素：系统回顾和荟萃分析

背景与目的未破裂颅内动脉瘤（UCAs）择期治疗后30天的意外再入院是一项重大的临床和经济负担。报告的再入院率差异很大，早期再住院的预测因素仍然难以捉摸。本荟萃分析评估了30天非计划再入院的患病率，并确定了与再入院风险增加相关的预测因素。方法遵循PRISMA指南，检索截至2025年10月的数据库，报告显微手术夹夹或血管内治疗uca后30天的计划外再入院。采用随机效应模型。风险比（RR）用于二分类变量，平均差异（MD）用于连续变量，合并患病率估计使用广义线性混合模型。结果：我们的分析包括7项研究的70,463例UCAs患者；3655人经历了30天的计划外再入院。再入院率为4.8% (95% CI, 3.0-7.5%)，显微手术和血管内治疗的再入院率无显著差异（5.9% vs 3.4%; P = 0.26）。一些合并症与再入院风险增加显著相关，包括高血压、高脂血症、糖尿病和抗凝剂的使用。指数住院时间也与较高的再入院风险相关。年龄、性别、吸烟状况和抗血小板使用不是显著的预测因素。结论：本荟萃分析发现，选择性uca治疗后30天意外再入院的发生率为4.8%。这些发现表明，对于接受UCA修复的患者，特别是那些有心脏代谢合并症和复杂指数住院的患者，需要仔细的风险分层和术前合并症管理。在高危患者中实施这些策略可能有助于减少可预防的再入院，并提高医疗资源的利用率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurochirurgie 医学-临床神经学

CiteScore

2.70

自引率

6.20%

发文量

100

审稿时长

29 days

期刊介绍： Neurochirurgie publishes articles on treatment, teaching and research, neurosurgery training and the professional aspects of our discipline, and also the history and progress of neurosurgery. It focuses on pathologies of the head, spine and central and peripheral nervous systems and their vascularization. All aspects of the specialty are dealt with: trauma, tumor, degenerative disease, infection, vascular pathology, and radiosurgery, and pediatrics. Transversal studies are also welcome: neuroanatomy, neurophysiology, neurology, neuropediatrics, psychiatry, neuropsychology, physical medicine and neurologic rehabilitation, neuro-anesthesia, neurologic intensive care, neuroradiology, functional exploration, neuropathology, neuro-ophthalmology, otoneurology, maxillofacial surgery, neuro-endocrinology and spine surgery. Technical and methodological aspects are also taken onboard: diagnostic and therapeutic techniques, methods for assessing results, epidemiology, surgical, interventional and radiological techniques, simulations and pathophysiological hypotheses, and educational tools. The editorial board may refuse submissions that fail to meet the journal''s aims and scope; such studies will not be peer-reviewed, and the editor in chief will promptly inform the corresponding author, so as not to delay submission to a more suitable journal. With a view to attracting an international audience of both readers and writers, Neurochirurgie especially welcomes articles in English, and gives priority to original studies. Other kinds of article - reviews, case reports, technical notes and meta-analyses - are equally published. Every year, a special edition is dedicated to the topic selected by the French Society of Neurosurgery for its annual report.