结果蛛网膜下腔出血后引入neurocritical保健服务(P3.106)

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目的:我们的目的是确定是否引进专用Neurocritical保健服务(nc)提高非创伤性蛛网膜下腔出血患者预后。背景:蛛网膜下腔出血(SAH)病死率居高不下,尽管改善治疗。此外,大于25 [percnt]的潜在寿命年损失通过中风相关长官。这些患者需要积极,密集,multispecialty和多学科优化结果。不幸的是并不是所有的医院都有能力提供这种级别的护理。在我们的机构,Neurocritical保健服务开始在有执照的指导下neurointensivist 2012年1月。设计/方法:前瞻性收集的数据回顾了。UHC数据库为加州大学圣地亚哥了识别所有非创伤性蛛网膜下腔出血患者4/1/2011和9/15/2014之间。基本的人口统计数据提取。结果变量包括绝对重症监护室(ICU)和医院的长度保持(洛杉矶),观察到洛杉矶/预期,绝对和观察/预期死亡率,放电的目的地。 Outcomes prior to the introduction of a neurocritical care service (“before”) were compared with outcomes after the NCS began 1/1/2012 (“after”). RESULTS: 57 cases (2.7 cases/month) of SAH before and 115 cases (3.5 cases/month) after the introduction of the neurocritical care service were reviewed. Mean age was similar; however, males constituted 33[percnt] of the patient population before compared with 53[percnt] after (p=0.01). More than twice as many patients arrived via transfer from another facility after the NCS began (38[percnt] versus 15[percnt]). Average LOS improved from 22.6 days (before) to 15.6 days (after), p=0.04. Observed/expected LOS improved from 1.46 to 1.00 (p=0.03). Absolute mortality rates and observed/expected mortality rates were similar. Discharge destination was comparable. CONCLUSION: At our institution, we saw improvements in absolute and observed/expected LOS, as well as an increase in volume of patients after a neurocritical care service was established.

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