Artikel
Update: Trends in the treatment of intracranial aneurysms in Austria 1999–2013 – A population-based study using administrative data
Suche in Medline nach
Autoren
Veröffentlicht: | 8. Juni 2016 |
---|
Gliederung
Text
Objective: The structure of the public health system in Austria allows for an analysis of trends in population-based data regarding incidence, treatment modality and outcome for intracranial aneurysms (IAs) with minimal inclusion bias.
Method: All IAs treated between 1999 and 2013 were identified using the public health services database by cross-searching for ICD-10 Codes I60.- I61.- and I67.1 and relevant diagnosis-related groups among all patients admitted to Austrian public hospitals. Standardized incidence, annual percent change (with 95% CI) and temporal trend analysis (Joinpoint Regression Program, Version 4.2.0.0) in treatment modality (clip vs. coil) were calculated.
Results: 700 IAs are treated per year in Austria. An increase 1999-2009 was due to a statistically significant increase of unruptured IAs (UIAs) (+11.3% p.a., 95%CI +8.5 to +14.1%), a decrease 2009-2013 due to a significant decrease of ruptured aneurysms (RAs) 2009-2013 (-6.0 % p.a., 95%CI -11.3 to -0.4%).The absolute number of RAs p.a. was 338 (minimum, 2012/2013) to 447 (maximum, 2009). For RAs, we observed a statistically significant decrease of the average annual percent change 1999 - 2013 (- 1.5% p a) and a statistically significant decreasing trend 2009 -2013. The age-adjusted incidence rate for RAs was 4.3/100000/a (mean). Endovascular treatment significantly increased 1999-2008 (+11.9% p.a.) and decreased (n.s.) 2008 - 2013. Microsurgical treatment increased statistically significant 1999 -2001 (+30.9%) and 2001 - 2013 (+ 7.7% p.a.).
Conclusions: Population-based data indicate that the number of ruptured intracranial aneurysms decreases after 2009. Microsurgical treatment of intracranial aneurysms remains a widely used treatment modality.