Regional differences in mortality among patients with ruptured intracranial aneurysms in Denmark

INTRODUCTION. Intracranial aneurysms are a serious clinical condition. Recent annual reports from the Danish Stroke Registry indicate a 30-day mortality rate of 27%, with notable regional variation ranging from 20% to 36%. This study aimed to examine whether these regional disparities in mortality are attributable to differences in demographic, clinical or treatment-related factors among the four Danish neurosurgical departments. METHODS. This multicentre registry-based cohort study utilised data from DanStroke. Differences in risk factors, mortality and neurological complications are presented as odds ratios with 95% confidence intervals calculated in a logistic regression model. RESULTS. A total of 1,426 patients were registered. The results of this study show that the patient population varies regionally, with patients admitted to Odense University Hospital (OUH) and Aalborg University Hospital (AaUH) generally being older and in a poorer clinical condition than patients admitted to Rigshospitalet (RH), which explains why fewer patients at the OUH and the AaUH received closure of the aneurysm. These regional differences contribute to the observed differences in mortality between the four neurosurgical departments. Importantly, among patients who received closure of the aneurysm, no significant difference in mortality was observed across departments. CONCLUSIONS. The mortality rate following intracranial aneurysmal haemorrhage is high in Denmark. Regional differences in mortality may reflect variations in the patient population and logistical aspects of transport, highlighting the importance of considering these parameters when comparing departments.