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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.4
- 발행연도
- 2021.12
- 수록면
- 327 - 333 (7page)
- DOI
- doi.org/10.7461/jcen.2021.E2021.06.001
이용수
초록· 키워드
오류제보하기
Objective: Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating cerebrovascular event; patients are routinely admitted to the intensive care unit (ICU) for initial management. Because complications may be delayed, unplanned ICU readmissions can occur. Therefore, in this study we evaluate the rate of and factors associated with readmission after aSAH and identify if readmission is associated with poor clinical outcomes.
Methods: We retrospectively reviewed the medical records of all patients receiving surgical or endovascular treatment for aSAH and admitted to the ICU between January 2008 and December 2019. We categorized patients by readmission and analyzed their clinical parameters.
Results: Of the 345 patients who transferred to ward-level care after an initial ICU stay (Group 2), 27 (7.3%) were readmitted to the ICU (Group 1). History of hypertension (HTN), initial Glasgow Coma Scale (GCS) score, modified Fisher grade, and vasospasm therapy during first ICU stay were significantly different between the groups. The most common reason for readmission was delayed cerebral ischemia (DCI; 70.3%; OR 5.545; 95% CI 1.25?24.52; p=0.024). Comorbid HTN (OR 5.311; 95% CI 1.75?16.12; p=0.03) and vasospasm therapy during first ICU stay (OR 7.234; 95% CI 2.41?21.7; p＜0.01) also were associated with readmission. Readmitted patients had longer hospital stay and lower GCS scores at discharge (p＜0.01).
Conclusions: DCI was the most common cause of ICU readmission in patients with aSAH. Readmission may indicate clinical deterioration, and patients who are at a high risk for DCI should be monitored to prevent readmission.
목차
등록된 정보가 없습니다.
참고문헌 (15)
참고문헌 신청
Dasenbrock HH / 2016 / Hospital-acquired infections after aneurysmal subarachnoid hemorrhage : a nationwide analysis / World Neurosurg 88:459~474
Diringer MN / 2011 / Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the neurocritical care society’s multidisciplinary consensus conference / Neurocrit Care 15(2):211~240
Frontera JA / 2006 / Prediction of symptomatic vasospasm after subarachnoid hemorrhage : the modified fisher scale / Neurosurgery 59(1):21~27
Greenberg JK / 2017 / Predictors of 30-day readmission after aneurysmal subarachnoid hemorrhage : a case-control study / J Neurosurg 126(6):1847~1854
Jaeger M / 2007 / Continuous monitoring of cerebrovascular autoregulation after subarachnoid hemorrhage by brain tissue oxygen pressure reactivity and its relation to delayed cerebral infarction / Stroke 38(3):981~986
Diringer MN / 2011 / Critical care management of patients following aneurysmal subarachnoid hemorrhage: recommendations from the neurocritical care society’s multidisciplinary consensus conference / Neurocrit Care 15(2):211~240
Frontera JA / 2006 / Prediction of symptomatic vasospasm after subarachnoid hemorrhage : the modified fisher scale / Neurosurgery 59(1):21~27
Greenberg JK / 2017 / Predictors of 30-day readmission after aneurysmal subarachnoid hemorrhage : a case-control study / J Neurosurg 126(6):1847~1854
Jaeger M / 2007 / Continuous monitoring of cerebrovascular autoregulation after subarachnoid hemorrhage by brain tissue oxygen pressure reactivity and its relation to delayed cerebral infarction / Stroke 38(3):981~986
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