Introduction: To investigate the association of demographic, cardiovascular and metabolic factors with unruptured cerebral aneurysms in hospitalized patients with headache from a large nationwide registry.
Hypothesis: The presence of certain demographic, cardiovascular and metabolic factors may be associated with unruptured cerebral aneurysms in hospitalized patients with headache.
Methods: Hospitalized patients included in the nationwide inpatient sample (NIS) 2011 database with a confirmed discharge diagnosis of headache , as per the ICD-9-CM code 784.0 were identified. NIS is the largest all-payer inpatient database in the United States. Regression models were used to determine statistical associations.
Results: From 8,023,590 admissions in the NIS 2011 database, 88,953 patients with headache were identified. Patients had a mean age of 50.87(± 20.0 SD) years, 66.23% (58,919) were women. We used weighted analysis to estimate the national values. 411,054 Headache patients were thus analyzed with unruptured cerebral aneurysms identified in 2547 (0.62%) patients. Model was adjusted for Age, sex, race, income, residence, hypertension, cocaine use, smoking, renal cystic disease, hyperlipidemia, PVD, renal failure, liver failure, subarachnoid hemorrhage, head injury, hyponatremia, RA, obesity, heart failure, dehydration, diabetes, diabetic eye disease & neuropathy, abdominal aortic aneurysms, TAA, RAA, ILA and neck aneurysms.
Conclusions: Female sex, Non Caucasian Race, Median incomes, Hypertension, Cocaine abuse, Smoking, PVD , Rheumatoid Arthritis, and aneurysms of the thoracic aorta, renal and iliac arteries were independently associated with risk of unruptured cerebral aneurysms (P<0.05). Further prospective studies are needed to understand if causative relationships exist.