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Abstract Details

Safety and Clinical Outcome of Good-Grade Aneurysmal Subarachnoid Hemorrhage in Non-Intensive Care Units
Neuro Trauma, Critical Care, and Sports Neurology
P15 - Poster Session 15 (12:00 PM-1:00 PM)
13-018

The objective of this study is to compare the safety and clinical outcome of good-grade aSAH in relation to the duration of ICU admission vs. non-ICU admission alone.

Most patients with good-grade aneurysmal subarachnoid hemorrhage (aSAH) defined as Hunt and Hess I-II achieve favorable outcomes. The early recognition of and rapid intervention for complications justify the recommendation for intensive care unit (ICU) admission. 
We reviewed 242 records of patients with good-grade aSAH admitted in our hospital over the past five years. Three classifications were used for analyses based on the duration of admission: Group A (ICU days>non-ICU), Group B (non-ICU days>ICU days) and Group C (non-ICU only).  Primary outcome measures were mortality and modified Rankin Scale at discharge. Secondary outcome measures included complication rates and total length of hospital stay. The medical and surgical interventions were also compared.

Based on the duration of ICU admission, there were no significant differences in the mortality rate, functional outcome and medical and surgical interventions. Delayed cerebral ischemia and nosocomial infections were significantly higher in patients who were in the ICU (91.67% vs 8.33%, p<0.001 and 76.47% vs 23.53%, p<0.001, respectively). On the other hand, rebleeding was significantly higher in patients in the non-ICU group (75%, p=0.02). Patients who developed complications, regardless of location had a significantly longer total hospital stay compared to those who did not develop complications (p<0.05)

In our setting, the admission of good-grade aSAH patients in a non-ICU setting may be safe and may decrease the likelihood of developing nosocomial infection. The development of complications is a predictor of unfavorable outcome and mortality and is consequently associated with longer hospital stay.

Authors/Disclosures
Jose Danilo B. Diestro, MD (St. Michael's Hospital, University of Toronto)
PRESENTER
Dr. Diestro has nothing to disclose.
Clare Angeli G. Enriquez, MD (Angeles University Foundation Medical Center) No disclosure on file
No disclosure on file
Romergryko G. Geocadin, MD, FÂé¶¹´«Ã½Ó³»­ (Johns Hopkins University School of Medicine) Dr. Geocadin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Medicolegal Consulting.
No disclosure on file