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Introduction Intracranial arteriovenous malformations (AVMs) are managed surgically, endovascularly, or hibridly. Different treatment modalities potentially impact outcomes. National-level studies remain limited.Aim of Study To determine predictors of in-hospital mortality for intracranial AVMs in different treatment approaches.Method We conducted retrospective cohort study using National Inpatient Sample (NIS) database (2016–2022). Patients with intracranial AVMs who underwent surgical (n=1749), endovascular (n=1826), or combined intervention (n=560) were included. Demographic, clinical, and treatment characteristics were compared. Categorical and continuous variables were compared using Chi-square and Mann-Whitney U tests, respectively. Univariate and multivariate analyses, including logistic regression, were performed to identify predictors of in-hospital mortality. Analyses were conducted using R software (v4.4.3).Abstract A364 Table 1Univariate and multivariate logistic regression analyses of predictors of in-hospital mortality in patients who underwent single-modality intervention only (either surgical or endovascular). APR-DRG = All Patient Refined-Diagnosis Related Groups, OR = odds ratio; CI = confidence interval. Variables with an asterisk (*) are log transformedResults Mean age of cohort was 43.59 years. Surgically treated patients were younger than endovascularly treated ones (43.1 vs. 44.6, p=0.046). Ruptured AVMs were more common in surgical group, while elective admissions were higher in endovascular group (p<0.001). In univariate analysis, variables significantly associated with in-hospital mortality included age, AVM rupture, external ventricular drainage (EVD) placement, All Patient Refined-Diagnosis-Related Groups (APR-DRG) subclassifications, hospital charges, cardiovascular comorbidities, emergency department (ED) admission, and seizures ( table 1). Multivariate analysis identified age (OR=1.016), EVD (OR=1.66), APR-DRG risk (OR=2.84), severity (OR=4.07), and seizures (OR=0.60) as independent mortality predictors; treatment modality was not. For combined vs. single interventions, univariate predictors of mortality were similar (table 2). Multivariate predictors included age (OR=1.019), EVD (OR=1.882), APR-DRG risk (OR=2.869), and severity (OR=4.751). Whereas treatment modality, hospital charges, ED admission, and seizures were not significant.Abstract A364 Table 2Logistic regression analyses were conducted to evaluate predictors of in-hospital mortality in the whole cohort of patients who underwent any intervention (surgical, endovascular, or both). APR-DRG = All Patient Refined-Diagnosis Related Groups, OR = odds ratio; CI = confidence interval. Variables with an asterisk (*) are log transformedConclusion Age, EVD placement, and APR-DRG scores independently predicted in-hospital mortality. Treatment type was not significant predictor.Conflict of Interest No