Hospitalization Rates, Semiology and Outcomes of Brain Arteriovenous Malformations in an Adult Population in the United States

Abstract

Background— Data regarding national estimates of brain arteriovenous malformation (BAVM) among adults in
United States is not available.
Objective— To characterize inpatient burden, expenditures, associated comorbidities, and treatments of BAVM
among adults (≥18 years) in United States.
Methods— We identified demographic, clinical characteristics, hospitalization outcomes and costs of BAVM
patients in 2016 in United States using Nationwide Inpatient Sample. Outcome was categorized based on discharge
disposition into none to minimal and moderate to severe disability.
Results— An estimated 7735 patients were admitted with the diagnosis of BAVM (mean age [SD] 52 years [18]);
3920 (50.7%) were men) including Whites (n= 4605, 59.5%), African Americans (n=1120, 14.5%) and Hispanic
(n=1060, 13.7%). Ruptured BAVM patients (n=1675, 21.6%) presented with intracerebral hemorrhage (n=1190,
71%), subarachnoid hemorrhage (n=270, 16.1%), or both (n=215, 12.8%) and seizures (n=255, 15.2%). None to
minimal disability and moderate to severe disability was seen in 5180 (67%) and 2345 (30.3%) of the patients,
respectively. In hospital mortality was 2.6% (n=200). Average length of stay [SD] was 6.5 days [8.6] with mean hos
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pitalization cost [SD] of $29,379.5 (35198.2). Age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02-1.07;
p<0.0001) and presence of intracerebral hemorrhage (OR 5.79 95% CI 2.85-11.77; p<0.0001) were independently
associated with in hospital mortality.
Conclusions— We provide one of the first national estimates and associated outcomes of hospital admissions for
BAVM among adults in United States. Although in hospital mortality was low, moderate to severe disability was seen
in one third of the hospitalized patients.