Endovascular aneurysm closure during out of office hours is not related to complications or outcome

Neuroradiology. 2020 Jun;62(6):741-746. doi: 10.1007/s00234-019-02355-1. Epub 2020 Feb 7.


Purpose: A possible disadvantage of endovascular occlusion outside work hours is that complex procedures might expose patients to additional risk when performed in a suboptimal setting. In this prospective cohort study, we evaluated whether treatment during out of office hours is a risk factor for per-procedural complications and clinical outcome.

Methods: We included 471 endovascular-treated, consecutive aneurysmal subarachnoid hemorrhage patients (56.6 ± 13.1, 69% female), from two prospective observational databases which were retrospectively analyzed. Primary outcome was the occurrence of per-procedural complications. Secondary outcomes were good clinical outcome (modified ranking scale ≤ 2) and death at 6-month follow-up. We determined odds ratios (OR) with 95% confidence intervals (CI) by ordered polytomous logistic regression analysis and adjusted odds ratios (aOR) for age, World Federation of Neurosurgical Societies grade, and time to treatment.

Results: Most patients were treated during office hours (363/471; 77.1%). Treatment during out of office hours did not result in an increased risk of per-procedural complications (OR 0.85 (95% CI 0.53-1.37; p = 0.51). Patients treated during out of office hours displayed similar odds of good clinical outcome and death after 6 months (OR 1.14, 95% CI 0.68-1.97 and 1.16 95% CI 0.56-2.29, respectively) compared to patients treated during office hours.

Conclusion: In our study, endovascular coil embolization during out of office hours did not expose patients to an increased risk of procedural complications or affect functional outcome after 6 months.

Keywords: Aneurysmal subarachnoid hemorrhage; Cohort study; Outcome research; Patient safety; Risk factors in epidemiology.

MeSH terms

  • After-Hours Care*
  • Aneurysm, Ruptured / therapy*
  • Embolization, Therapeutic*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Health Care*
  • Registries
  • Risk Factors
  • Subarachnoid Hemorrhage / therapy*