Discharge Site Is Associated With Long-Term Functional Outcomes in Patients With Ruptured Intracranial Aneurysms

To evaluate the impact of discharge destination on long-term functional outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH) and its association with achieving functional independence.

This retrospective cohort study included patients with aSAH treated endovascularly at a tertiary neurovascular center between October 2019 and November 2024. Patients who died before hospital discharge were excluded. Group comparisons were performed using one-way analysis of variance, Kruskal-Wallis, paired-sample t-tests and Pearson's χ². Multivariable logistic regression was used to assess the association between discharge site and functional independence achievement, adjusting for age, sex, World Federation of Neurosurgical Societies (WFNS) grade and modified Rankin Scale (mRS) score at discharge.

A total of 213 patients (mean age 55.9 ± 13.7 years; 77% female) were included. Hypertension (57.7%) and previous smoking (45.1%) were the most common risk factors. Significant differences in age, sex, WFNS grade and modified Fisher Scale scores were observed across discharge groups. While patients discharged home had better overall outcomes, those with poor WFNS grades showed greater reductions in mRS at 6 and 12 months when discharged to an acute rehabilitation center. Regression analysis demonstrated that discharge to an acute rehabilitation center was independently associated with higher odds of functional independence, while discharge to a primary care hospital decreased these odds.

Discharge to a primary care hospital after aSAH was associated with worse long-term outcomes. In contrast, early transfer to an acute rehabilitation center significantly improved functional independence, particularly among patients with poor baseline neurological status.