Table 4.
Multivariable logistic regression models predicting hospital mortality by US region.
| Variable | Adjusted odds ratio estimates (95% confidence intervals) | P value | ||||
|---|---|---|---|---|---|---|
| Hospital mortality | ||||||
| Years: 2014–2018 vs. 2009–2013 | 0.71 (0.69–0.74) | <0.0001 | ||||
| Northeast | Midwest | South | West | Main effect | Regional interaction Effect | |
| Aneurysm repair | ||||||
| Any procedure | 0.25 (0.12–0.54) | 0.24 (0.11–0.54) | 0.61 (0.39–0.96) | 0.68 (0.46–1.02) | <0.0001 | 0.001 |
| Endovascular coiling | 0.53 (0.47–0.61) | 0.50 (0.44–0.57) | 0.41 (0.37–0.46) | 0.53 (0.45–0.63) | ||
| Surgical clipping | 0.34 (0.30–0.40) | 0.33 (0.28–0.37) | 0.37 (0.34–0.42) | 0.42 (0.37–0.48) | ||
| Age, per year | 1.02 (1.02–1.024) | 1.02 (1.02–1.021) | 1.02 (1.02–1.022) | 1.02 (1.02–1.023) | <0.0001 | 0.192 |
| Presence of a comorbidity flaga | 0.77 (0.69–0.85) | 0.74 (0.66–0.83) | 0.7 (0.66–0.80) | 0.82 (0.72–0.94) | <0.0001 | 0.528 |
| Severity of illness (SOI) on admissionb | ||||||
| Moderate SOI | 2.36 (1.7–3.3) | 1.9 (1.41–2.67) | 1.91 (1.42–2.55) | 1.66 (1.08–2.56) | <0.0001 | 0.002 |
| Major SOI | 3.25 (2.39–4.42) | 2.76 (2.05–3.70) | 2.92 (2.23–3.81) | 2.73 (1.82–4.09) | ||
| Extreme SOI | 15.1 (11.1–20.5) | 11.90 (8.9–16.0) | 14.4 (11.0–18.8) | 13.13 (8.8–19.7) | ||
| Presence of a hospital complication flagc | 1.53 (1.42–1.65) | 1.64 (1.52–1.77) | 1.43 (1.34–1.53) | 1.58 (1.44–1.73) | <0.0001 | 0.068 |
| Nimodipine use | 0.40 (0.35–0.47) | 0.43 (0.37–0.50) | 0.39 (0.35–0.45) | 0.48 (0.40–0.58) | <0.0001 | 0.289 |
| Vasopressor used | 2.58 (2.3–2.94) | 2.55 (2.24–2.90) | 2.60 (2.33–2.91) | 2.45 (2.09–2.87) | <0.0001 | 0.943 |
| Use of intra–arterial vasodilator therapye | 0.48 (0.41–0.56) | 0.51 (0.45–0.58) | 0.47 (0.42–0.52) | 0.50 (0.42–0.59) | <0.0001 | 0.725 |
| Cerebral angioplasty | 0.77 (0.64–0.94) | 0.71 (0.58–0.86) | 0.81 (0.68–0.96) | 0.71 (0.54–0.92) | 0.009 | 0.715 |
SOI, Severity of Illness. aDefined as any medical comorbidity prior to ictus. bDefined by the All Patients Refined Diagnosis Related Groups (APR-DRG) disease-specific risk-of-mortality severity index; reference group: minor SOI. cDefined as any hospital complication during admission. dIncluded intravenous norepinephrine, epinephrine, dopamine, vasopressin, dobutamine, milnirone. eIncluded intra-arterial nicardipine, verapamil, milnirone, papaverine.