Stroke units could be a valid alternative to intensive care units for patients with low‐grade aneurysmal subarachnoid haemorrhage.
Saved in:
| Title: | Stroke units could be a valid alternative to intensive care units for patients with low‐grade aneurysmal subarachnoid haemorrhage. |
|---|---|
| Authors: | Llull, L. (AUTHOR), Mayà, G. (AUTHOR), Torné, R. (AUTHOR), Mellado‐Artigas, R. (AUTHOR), Renú, A. (AUTHOR), López‐Rueda, A. (AUTHOR), Laredo, C. (AUTHOR), Culebras, D. (AUTHOR), Ferrando, C. (AUTHOR), Blasco, J. (AUTHOR), Amaro, S. (AUTHOR), Chamorro, Á. (AUTHOR) |
| Source: | European Journal of Neurology. Feb2021, Vol. 28 Issue 2, p500-508. 9p. |
| Subjects: | Intensive care patients, Stroke units, Subarachnoid hemorrhage, Intensive care units, Hospital admission & discharge |
| Abstract: | Background and purpose: According to current guidelines, patients with aneurysmal subarachnoid haemorrhage (aSAH) are mostly managed in intensive care units (ICUs) regardless of baseline severity. We aimed to assess the prognostic and economic implications of initial admission of patients with low‐grade aSAH into a stroke unit (SU) compared to initial ICU admission. Methods: We reviewed prospectively registered data from consecutive aSAH patients with a World Federation of Neurosurgery Societies grade <3, admitted to our Comprehensive Stroke Centre between April 2013 and September 2018. Clinical and radiological baseline traits, in‐hospital complications, length of stay (LOS) and poor outcome at 90 days (modified Rankin Scale score > 2) were compared between the ICU and SU groups in the whole population and in a propensity‐score‐matched cohort. Results: Of 131 patients, 74 (56%) were initially admitted to the ICU and 57 (44%) to the SU. In‐hospital complication rates were similar in the ICU and SU groups and included rebleeding (10% vs. 7%; P = 0.757), angiographic vasospasm (61% vs. 60%; P = 0.893), delayed cerebral ischaemia (12% vs. 12%; P = 0.984), pneumonia (6% vs. 4%; P = 0.697) and death (10% vs. 5%; P = 0.512). LOS did not differ between groups (median [interquartile range] 22 [16–30] vs. 19 [14–26] days; P = 0.160). In adjusted multivariate models, the location of initial admission was not associated with long‐term poor outcome either in the whole population (odds ratio [OR] 1.16, 95% confidence interval [CI] 0.32–4.19; P = 0.825) or in the matched cohort (OR 0.98, 95% CI 0.24–4.06; P = 0.974). Conclusions: A dedicated SU, with care from a multidisciplinary team, might be an optimal alternative to ICU for initial admission of patients with low‐risk aSAH. [ABSTRACT FROM AUTHOR] |
| Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
|
Full text is not displayed to guests.
Login for full access.
|
|
| FullText | Links: – Type: pdflink Text: Availability: 1 |
|---|---|
| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 148144999 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Stroke units could be a valid alternative to intensive care units for patients with low‐grade aneurysmal subarachnoid haemorrhage. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Llull%2C+L%2E%22">Llull, L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mayà%2C+G%2E%22">Mayà, G.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Torné%2C+R%2E%22">Torné, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mellado‐Artigas%2C+R%2E%22">Mellado‐Artigas, R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Renú%2C+A%2E%22">Renú, A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22López‐Rueda%2C+A%2E%22">López‐Rueda, A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Laredo%2C+C%2E%22">Laredo, C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Culebras%2C+D%2E%22">Culebras, D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ferrando%2C+C%2E%22">Ferrando, C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Blasco%2C+J%2E%22">Blasco, J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Amaro%2C+S%2E%22">Amaro, S.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chamorro%2C+Á%2E%22">Chamorro, Á.</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Journal+of+Neurology%22">European Journal of Neurology</searchLink>. Feb2021, Vol. 28 Issue 2, p500-508. 9p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Intensive+care+patients%22">Intensive care patients</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+units%22">Stroke units</searchLink><br /><searchLink fieldCode="DE" term="%22Subarachnoid+hemorrhage%22">Subarachnoid hemorrhage</searchLink><br /><searchLink fieldCode="DE" term="%22Intensive+care+units%22">Intensive care units</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+admission+%26+discharge%22">Hospital admission & discharge</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background and purpose: According to current guidelines, patients with aneurysmal subarachnoid haemorrhage (aSAH) are mostly managed in intensive care units (ICUs) regardless of baseline severity. We aimed to assess the prognostic and economic implications of initial admission of patients with low‐grade aSAH into a stroke unit (SU) compared to initial ICU admission. Methods: We reviewed prospectively registered data from consecutive aSAH patients with a World Federation of Neurosurgery Societies grade <3, admitted to our Comprehensive Stroke Centre between April 2013 and September 2018. Clinical and radiological baseline traits, in‐hospital complications, length of stay (LOS) and poor outcome at 90 days (modified Rankin Scale score > 2) were compared between the ICU and SU groups in the whole population and in a propensity‐score‐matched cohort. Results: Of 131 patients, 74 (56%) were initially admitted to the ICU and 57 (44%) to the SU. In‐hospital complication rates were similar in the ICU and SU groups and included rebleeding (10% vs. 7%; P = 0.757), angiographic vasospasm (61% vs. 60%; P = 0.893), delayed cerebral ischaemia (12% vs. 12%; P = 0.984), pneumonia (6% vs. 4%; P = 0.697) and death (10% vs. 5%; P = 0.512). LOS did not differ between groups (median [interquartile range] 22 [16–30] vs. 19 [14–26] days; P = 0.160). In adjusted multivariate models, the location of initial admission was not associated with long‐term poor outcome either in the whole population (odds ratio [OR] 1.16, 95% confidence interval [CI] 0.32–4.19; P = 0.825) or in the matched cohort (OR 0.98, 95% CI 0.24–4.06; P = 0.974). Conclusions: A dedicated SU, with care from a multidisciplinary team, might be an optimal alternative to ICU for initial admission of patients with low‐risk aSAH. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=148144999 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1111/ene.14548 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 500 Subjects: – SubjectFull: Intensive care patients Type: general – SubjectFull: Stroke units Type: general – SubjectFull: Subarachnoid hemorrhage Type: general – SubjectFull: Intensive care units Type: general – SubjectFull: Hospital admission & discharge Type: general Titles: – TitleFull: Stroke units could be a valid alternative to intensive care units for patients with low‐grade aneurysmal subarachnoid haemorrhage. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Llull, L. – PersonEntity: Name: NameFull: Mayà, G. – PersonEntity: Name: NameFull: Torné, R. – PersonEntity: Name: NameFull: Mellado‐Artigas, R. – PersonEntity: Name: NameFull: Renú, A. – PersonEntity: Name: NameFull: López‐Rueda, A. – PersonEntity: Name: NameFull: Laredo, C. – PersonEntity: Name: NameFull: Culebras, D. – PersonEntity: Name: NameFull: Ferrando, C. – PersonEntity: Name: NameFull: Blasco, J. – PersonEntity: Name: NameFull: Amaro, S. – PersonEntity: Name: NameFull: Chamorro, Á. IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2021 Type: published Y: 2021 Identifiers: – Type: issn-print Value: 13515101 Numbering: – Type: volume Value: 28 – Type: issue Value: 2 Titles: – TitleFull: European Journal of Neurology Type: main |
| ResultId | 1 |
