Next day discharge after elective intracranial aneurysm coiling: is it safe?

Abstract

There is a paucity of literature on early discharge after elective aneurysm treatment. We hypothesize that patient discharge on the next day is not associated with an increase in post-discharge adverse events. We retrospectively reviewed elective coiling procedures between 2009 and 2013. The primary outcome measure was 30-day adverse events (emergency department visits, readmission or prolonged admission >30 days, and death). We evaluated the association between early and standard discharge for the primary outcome using the Fisher exact test. We also assessed the association of the primary outcome with other patient and technical variables as well as findings on pre-discharge diffusion weighted imaging. We included 97 patients. Median length of hospital stay (LOS) was 2.52 days, and in 26 patients (26.8%) LOS was <2 days. There was no significant difference in post-discharge adverse outcome rates between early and standard discharge groups (19.2% vs 18.3%; p=1.000). The primary outcome was significantly associated with the use of flow diverters (p=0.0287) and change in modified Rankin Scale category at discharge (p=0.0329). No significant association was noted between the outcome and the other variables including the presence of diffusion restriction pre-discharge (p>0.05). Patient discharge the next day after elective intracranial aneurysm coiling is not associated with an increase in 30-day adverse outcomes. A prospective study investigating early discharge in elective treatment is warranted. OHSN-REB #20130786-01H.