Evidence map›Paper›PMID 41540309›Full record

SynthesisNeurocritical care2026

Systematic Review of Direct Hospital Costs Associated with Aneurysmal Subarachnoid Hemorrhage Management.

Friso P Mulder, Jeroen T J M van Dijck, Samuel A Corper, Rick J G Vreeburg, Wouter A Moojen

Abstract readSystematic Review
In one paragraph

Synthesis in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Friso P MulderDepartment of Neurosurgery, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden and The Hague, the Netherlands. f.p.mulder@lumc.nl.ORCID 0009-0003-7790-522X
Jeroen T J M van DijckDepartment of Neurosurgery, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden and The Hague, the Netherlands.
Samuel A CorperDepartment of Neurosurgery, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden and The Hague, the Netherlands.
Rick J G VreeburgDepartment of Neurosurgery, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden and The Hague, the Netherlands.
Wouter A MoojenDepartment of Neurosurgery, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, University Neurosurgical Center Holland, Leiden and The Hague, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAneurysmal subarachnoid hemorrhage (aSAH) is a severe condition associated with significant morbidity, mortality, and disability. In-hospital care of aSAH is complex and resource intensive, posing substantial financial challenges to health care systems. To support efficient resource allocation, health policy decision-making, and care optimization, this systematic review aimed to assess and synthesize literature on direct in-hospital costs of aSAH management.

methodsA comprehensive search was performed in July 2025 across PubMed, Medline, Web of Science, Cochrane Library, Emcare, Embase (Ovid), and PsycINFO to identify studies reporting direct in-hospital costs related to aSAH. Reporting completeness and risk of bias were assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 and the Joanna Briggs Institute checklists. Reported costs were narratively synthesized and converted to 2024 US dollars using the CCEMG-EPPI-Centre Cost Converter. In addition, a random-effects meta-analysis was conducted to compare in-hospital costs between surgical clipping and endovascular coiling.

resultsThe database search identified 1,591 articles, of which 30 were included. The average reporting completeness was 74% (range 46-91%) and methodological quality 76% (range 41-100%). Reported in-hospital costs ranged from $11,884 to $459,579 (median $68,711), being the highest in North America, followed by Europe and Asia. Costs as a percentage of gross domestic product per capita ranged from 35 to 639%. Key cost drivers included length of stay, clinical severity, and complications. The meta-analysis found no significant cost difference between clipping and coiling (mean difference $3,057, 95% confidence interval -$11,597 to $17,710).

conclusionsIn-hospital costs for aSAH management are substantial and vary widely due to differences in health care systems, study methodology, and clinical practices. The quality of economic evaluations remains inconsistent, underscoring the need for more standardized and transparent methodologies. As global health care spending increases, high-quality economic evidence is essential for equitable and sustainable care.

Indexed as

Endovascular ProceduresHospital CostsIntracranial AneurysmSubarachnoid HemorrhageHumansAneurysmal subarachnoid hemorrhageEndovascular coilingHealth economicsIn-hospital costsSurgical clippingSystematic review

Identifiers

PMID41540309
PMCPMC13053336

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.