Abstract 253: Effect of Discharge Site on the Functional Outcome of Patients with Ruptured Intracranial Aneurysms

Introduction/PurposeAneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality following intracranial aneurysm (IA) rupture. While various clinical measures have been explored to improve outcomes, the impact of the discharge site post‐aSAH has been limitedly explored. This study examines the effect of discharge site on functional outcomes at 6 and 12 months post‐aSAH.Materials and MethodsThis retrospective cohort study included patients with aSAH. Statistical analyses included paired‐sample t‐tests for dependent numerical variables, Pearson's χ2 for categorical variables, and multivariate logistic regression, controlled by age, sex and discharge modified Rankin Scale (mRS) to assess the impact of discharge site on functional outcomes. Patients who died before hospital discharge were excluded. Statistical significance was set at ≤ 0.05.Results184 patients were included (mean age of 56.6 years; 76.6% were female). Hypertension (58.2%) and previous smoking (43.5%) were the most common risk factors. At admission, the World Federation of Neurosurgical Societies (WFNS) grading scale was 41.8% in grade 1, 20.1% in 2, 2.7% in 3, 20.1% in 4, and 15.2% in 5. Patients discharged to specialized rehabilitation centers showed greater reductions in mRS across all groups, particularly those with poor baseline WFNS scores. While patients discharged home had better outcomes overall, those with poor baseline WFNS scores demonstrated significantly higher reductions in mRS at 6 and 12 months if discharged to a specialized rehabilitation center. Our multivariate regression model indicated that discharge to a specialized rehabilitation center increased the odds of a good functional outcome, whereas discharge to another hospital facility decreased these odds.ConclusionDischarge to a specialized rehabilitation center after aSAH improves long‐term outcomes, particularly for patients with poor baseline WFNS scores. Conversely, discharge to another hospital facility is associated with lower odds of a good functional outcome.