Âé¶¹´«Ã½Ó³»­

Âé¶¹´«Ã½Ó³»­

Explore the latest content from across our publications

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Intensive Care Resource Utilization in the Management of Intracerebral Hemorrhage
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
070

To investigate ICU-level resource utilization for patients admitted to the ICU with sICH. 

Admission to the intensive care unit (ICU) for management of spontaneous intracerebral hemorrhage (sICH) is standard practice at many hospitals. The proportion of patients admitted to the ICU who require ICU-level interventions and the specific types, quantities and duration of interventions administered have not been well delineated.

Patients admitted to the ICU with sICH between August 2017 and April 2019 were evaluated for inclusion. Retrospective chart reviews were performed. Abstracted data included demographics, sICH characteristics/etiology, prognostication scores, functional outcome scores, hospital/ICU length of stay (LOS), “non-value-added time” (defined as time spent waiting to transfer from the ICU after transfer order placed), and ICU-level interventions administered.

Of 274 patients screened, 204 met inclusion criteria for sICH based on SMASH-U criteria. 17% received no ICU-level interventions, with average ICU LOS of 41.1 hours and “non-valued-added time” of 18 hours. 25% of patients received only 1 ICU-level intervention, which in 70% of cases constituted vasoactive infusion for treatment hypertension. For those receiving only 1 ICU-level intervention, average ICU LOS was 42.2 hours and average “non-value-added time” was 15.3 hours; 65% of interventions were not continued beyond the first ICU day.

Current guidelines recommend that patients with sICH be admitted to an ICU or stroke unit. This study demonstrates that more than 42% of patients admitted received < 1 ICU-level intervention during their ICU stay. For those who received 1 intervention, this was not continued beyond the first day in most cases.  “Non-value-added time” accounted for 44% of ICU LOS for patients receiving no ICU-level interventions and 36% of ICU LOS for patients receiving 1 ICU-level intervention. Opportunities exist to improve value-based care delivery in sICH. Triage to less resource intensive care settings may be more cost-effective without compromising clinical outcomes.
Authors/Disclosures
Nhu-y Phan, MD
PRESENTER
Dr. Phan has nothing to disclose.
Casey Olm-Shipman, MD (UNC School of Medicine) Dr. Olm-Shipman has nothing to disclose.