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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
Published on: August 30, 2020
Multidrug-resistant organisms (MDROs) in patients with subarachnoid hemorrhage (SAH)
Ha-Young Rhim1, Sae-Yeon Won2, Sepide Kashefiolasl2
1Department of Neurosurgery, University Hospital, Goethe University, Frankfurt am Main, Germany. rhimha@yahoo.de.
Abstract:
Patient care in a neurointensive care unit (neuro-ICU) is challenging. Multidrug-resistant organisms (MDROs) are increasingly common in the routine clinical practice. We evaluated the impact of infection with MDROs on outcomes in patients with subarachnoid hemorrhage (SAH). A single-center retrospective analysis of SAH cases involving patients treated in the neuro-ICU was performed. The outcome was assessed 6 months after SAH using the modified Rankin Scale [mRS, favorable (0-2) and unfavorable (3-6)]. Data were compared by matched-pair analysis. Patient characteristics were well matched in the MDRO (n = 61) and control (n = 61) groups. In this center, one nurse was assigned to a two-bed room. If a MDRO was detected, the patient was isolated, and the nurse was assigned to the patient infected with the MDRO. In the MDRO group, 29 patients (48%) had a favorable outcome, while 25 patients (41%) in the control group had a favorable outcome; the difference was not significant (p > 0.05). Independent prognostic factors for unfavorable outcomes were worse status at admission (OR = 3.1), concomitant intracerebral hematoma (ICH) (OR = 3.7), and delayed cerebral ischemia (DCI) (OR = 6.8). Infection with MRDOs did not have a negative impact on the outcome in SAH patients. Slightly better outcomes were observed in SAH patients infected with MDROs, suggesting the benefit of individual care.
Insights
Multidrug-resistant organism (MDRO) infections did not negatively impact outcomes in subarachnoid hemorrhage (SAH) patients. SAH patients with MDROs showed similar or slightly better outcomes, possibly due to increased individual care.
Area of Science:
- Neuroscience
- Infectious Diseases
- Critical Care Medicine
Background:
- Multidrug-resistant organisms (MDROs) pose a growing challenge in neurocritical care settings.
- Subarachnoid hemorrhage (SAH) patients are susceptible to infections, complicating recovery.
- Understanding the impact of MDROs on SAH patient outcomes is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the effect of multidrug-resistant organism (MDRO) infections on patient outcomes following subarachnoid hemorrhage (SAH).
- To identify factors influencing outcomes in SAH patients, particularly in the context of MDRO presence.
Main Methods:
- A single-center retrospective analysis was conducted on SAH patients treated in a neurointensive care unit (neuro-ICU).
- Patients were divided into two groups: those with MDRO infections and a control group, matched by pair analysis.
- Outcomes were assessed at 6 months post-SAH using the modified Rankin Scale (mRS).
Main Results:
- No significant difference in favorable outcomes (mRS 0-2) was observed between the MDRO group (48%) and the control group (41%).
- Independent predictors for unfavorable outcomes included worse admission status, concomitant intracerebral hematoma (ICH), and delayed cerebral ischemia (DCI).
- SAH patients with MDROs exhibited slightly better outcomes, suggesting potential benefits from the intensified individual care provided.
Conclusions:
- Infection with multidrug-resistant organisms (MDROs) does not appear to negatively impact outcomes in subarachnoid hemorrhage (SAH) patients.
- The findings suggest that enhanced monitoring and individual care, often implemented for patients with MDROs, may contribute to favorable outcomes.
- Further research into the specific care interventions for MDRO-infected SAH patients is warranted to confirm these observations.
