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Background Prolonged hospitalization after standalone middle meningeal artery embolization (MMAE) for chronic subdural hematoma (cSDH) may be unnecessary given its minimally invasive endovascular profile — yet evidence-based discharge criteria remain undefined. We sought to identify admission-time predictors of short hospital stay and evaluate whether early discharge is associated with increased 90-day adverse events.Methods Retrospective cohort study using the MESH Registry across 24 international neurovascular centers (2015-2024). Patients undergoing standalone MMAE for symptomatic cSDH were included; exclusions were age <18, missing LOS data, in-hospital mortality, hospice discharge, and same-day discharge. Short-stay discharge was defined as LOS ≤2 days. Ten prespecified admission-time variables were entered into a multivariable logistic regression model with 500-iteration bootstrap validation. Safety was assessed via covariate-adjusted logistic regression, IPTW, GEE with robust center clustering, and MICE with delta-adjustment sensitivity analyses.Results Among 734 patients across 22 centers (mean age 72.8 years; 67.6% male), 141 (19.2%) achieved short-stay discharge. Median LOS was 6 days (IQR 3-11). Common comorbidities included hypertension (65.0%), cardiac disease (40.1%), and anticoagulation use (23.7%). Two factors independently predicted short-stay discharge: better baseline mRS (aOR 0.76 per point; 95% CI 0.63-0.91; P=0.003) and absence of anticoagulation (aOR 0.50; 95% CI 0.28-0.92; P=0.02). C-statistic was 0.649, suggesting institutional and social factors substantially influence discharge timing. The 90-day composite adverse event rate was 22.0% vs. 22.1% in short- versus long-stay patients (RD −0.1%; 95% CI −9.0% to 8.9%; aOR 0.98; 95% CI 0.54-1.76; P=0.94), consistent across IPTW (OR 0.94; 95% CI 0.52-1.70), GEE (aOR 0.89; 95% CI 0.42-1.88), and MICE (aOR 0.90; 95% CI 0.54-1.49) analyses. Reintervention was numerically higher in short-stay patients (9.8% vs. 5.8%; aOR 2.01; 95% CI 0.92-4.40; P=0.08), a signal warranting prospective evaluation.Conclusions Better baseline functional status and absence of anticoagulation identify patients most likely to achieve short-stay discharge after standalone MMAE. Early discharge was not associated with increased composite adverse events across all analytic approaches, supporting feasibility of accelerated discharge pathways in selected patients. The numerically higher reintervention rate and limited power to exclude modest safety differences underscore the need for prospective validation with standardized follow-up.Disclosures A. Terraciano: None. A. Karandish: None. H. Salim: None. M. Collaborators: None.