Impact of delayed transfer of critically ill stroke patients from the Emergency Department to the Neuro-ICU.
Neurocrit Care
; 13(1): 75-81, 2010 Aug.
Article
em En
| MEDLINE
| ID: mdl-20428969
ABSTRACT
BACKGROUND:
We sought to determine the effect of emergency department length of stay (ED-LOS) on outcomes in stroke patients admitted to the Neurological Intensive Care Unit (NICU).METHODS:
We collected data on all patients who presented to the ED at a single center from 1st February 2005 to 31st May 2007 with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), or transient ischemic attack (TIA) within 12 h of symptom onset. Data collected included demographics, admission/discharge National Institutes of Health Stroke Scale (NIHSS), discharge modified Rankin Score (mRS), and total ED length of stay. The effect of ED-LOS on discharge mRS, discharge NIHSS, and hospital LOS was assessed by logistic regression. Poor outcome was defined as mRS > or =4 at discharge.RESULTS:
Of 519 patients presenting to the ED, 75 (15%) were critically ill and admitted to the NICU (mean age 65 +/- 14 years, 31% men, and 37% Hispanic). Admission diagnosis included AIS (49%), ICH (47%), TIA (1%), and others (3%). Median ED-LOS was 5 h (IQR 3-8 h) and median hospital LOS was 7 days (IQR 3-15 days). In multivariate analysis, predictors of poor outcome included admission ICH (OR, 2.1; 95% CI, 1.1-4.3), NIHSS > or =6 (OR, 6.4; 95% CI, 2.3-17.9), and ED-LOS > or =5 h (OR, 3.8; 95% CI, 1.6-8.8). There was no association between ED-LOS and discharge NIHSS among survivors or total hospital LOS.CONCLUSION:
Among critically ill stroke patients, ED-LOS > or =5 h before transfer to the NICU is independently associated with poor outcome at hospital discharge.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transferência de Pacientes
/
Acidente Vascular Cerebral
/
Serviço Hospitalar de Emergência
/
Unidades de Terapia Intensiva
/
Tempo de Internação
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neurocrit Care
Assunto da revista:
NEUROLOGIA
/
TERAPIA INTENSIVA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos