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Medical complications drive length of stay after brain hemorrhage: a cohort study

Andrew M Naidech1, Bernard R Bendok, Paul Tamul

  • 1Department of Neurology, Northwestern University, 710 N Lake Shore Drive, 11th floor, Chicago, IL, 60611, USA. a-naidech@northwestern.edu

Neurocritical Care
|September 30, 2008
PubMed

Insights

Medical complications significantly increase length of stay (LOS) in patients with spontaneous subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH), even with intensive care protocols. Addressing these complications is key to reducing patient LOS.

Area of Science:

  • Neurocritical care
  • Intensive care medicine
  • Neurology

Background:

  • Longer length of stay (LOS) in ICU patients correlates with increased complications and costs.
  • Hospital protocols aim to reduce complications and LOS.
  • Spontaneous subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) are critical neurological events.

Purpose of the Study:

  • To investigate if medical complications increase LOS in SAH and ICH patients.
  • To assess the impact of complications after accounting for neurological injury severity.

Main Methods:

  • Prospective data collection on 122 SAH and 56 ICH patients (Feb 2006-Mar 2008).
  • Inclusion of a multidisciplinary Neuro-ICU team and established hospital protocols (glucose control, ventilator bundles, etc.).
  • Statistical analysis using univariate methods and linear regression.

Main Results:

  • Infection, fever, and acute lung injury were primary drivers of LOS in both SAH and ICH.
  • Vasospasm and Glasgow Coma Scale score influenced LOS in SAH.
  • Initial bleed volume was a significant factor for LOS in ICH.

Conclusions:

  • Medical complications continue to drive LOS in brain hemorrhage patients despite intensive care protocols.
  • Dedicated medical staff and evidence-based protocols did not eliminate preventable complications.
  • Further care modifications are needed to minimize LOS and prevent complications.
Abstract

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