The Safety and Feasibility of Admitting Patients With Intracerebral Hemorrhage to the Step-Down Unit

Shaheryar Hafeez, Reza Behrouz

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND: Intracerebral hemorrhage (ICH) is a devastating and costly condition. Although the American Heart Association/American Stroke Association recommends admitting patients with ICH to a neurocritical care unit (NCCU), this strategy may accrue unnecessary cost for patients with relatively milder presentation. We conducted a prospective observational study to determine the safety and feasibility of admitting patients with mild ICH directly to a step-down unit (SDU) instead of an NCCU.

METHODS: Consecutive patients with "mild presentation," defined as a combination of ICH score ≤2, National Institutes of Health Stroke Scale (NIHSS) ≤ 15, and Graeb score ≤2 (if intraventricular hemorrhage was present), were admitted to the SDU. Data were collected on age, gender as well as the initial NIHSS, Glasgow Coma Scale (GCS), ICH, and Graeb scores. Primary end point was any complication or death during hospital stay.

RESULTS: Twenty patients were admitted to the SDU. No patient was transferred to the NCCU from the SDU. One patient, who eventually died, had respiratory insufficiency due to hospital-acquired pneumonia.

CONCLUSION: Admission of ICH patients with mild symptoms to the SDU is safe and feasible. Larger prospective studies are needed to define the specific criteria for admission.

Original languageEnglish (US)
Pages (from-to)409-411
Number of pages3
JournalJournal of Intensive Care Medicine
Volume31
Issue number6
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Fingerprint

Cerebral Hemorrhage
Safety
National Institutes of Health (U.S.)
Stroke
Prospective Studies
Glasgow Coma Scale
Respiratory Insufficiency
Observational Studies
Length of Stay
Pneumonia
Hemorrhage
Costs and Cost Analysis

Keywords

  • acute stroke management
  • critical care
  • intracerebral hemorrhage

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

The Safety and Feasibility of Admitting Patients With Intracerebral Hemorrhage to the Step-Down Unit. / Hafeez, Shaheryar; Behrouz, Reza.

In: Journal of Intensive Care Medicine, Vol. 31, No. 6, 01.07.2016, p. 409-411.

Research output: Contribution to journalArticle

@article{bfd1d96147084ccea1e6c5bd77fad0a5,
title = "The Safety and Feasibility of Admitting Patients With Intracerebral Hemorrhage to the Step-Down Unit",
abstract = "BACKGROUND: Intracerebral hemorrhage (ICH) is a devastating and costly condition. Although the American Heart Association/American Stroke Association recommends admitting patients with ICH to a neurocritical care unit (NCCU), this strategy may accrue unnecessary cost for patients with relatively milder presentation. We conducted a prospective observational study to determine the safety and feasibility of admitting patients with mild ICH directly to a step-down unit (SDU) instead of an NCCU.METHODS: Consecutive patients with {"}mild presentation,{"} defined as a combination of ICH score ≤2, National Institutes of Health Stroke Scale (NIHSS) ≤ 15, and Graeb score ≤2 (if intraventricular hemorrhage was present), were admitted to the SDU. Data were collected on age, gender as well as the initial NIHSS, Glasgow Coma Scale (GCS), ICH, and Graeb scores. Primary end point was any complication or death during hospital stay.RESULTS: Twenty patients were admitted to the SDU. No patient was transferred to the NCCU from the SDU. One patient, who eventually died, had respiratory insufficiency due to hospital-acquired pneumonia.CONCLUSION: Admission of ICH patients with mild symptoms to the SDU is safe and feasible. Larger prospective studies are needed to define the specific criteria for admission.",
keywords = "acute stroke management, critical care, intracerebral hemorrhage",
author = "Shaheryar Hafeez and Reza Behrouz",
year = "2016",
month = "7",
day = "1",
doi = "10.1177/0885066615578113",
language = "English (US)",
volume = "31",
pages = "409--411",
journal = "Journal of Intensive Care Medicine",
issn = "0885-0666",
publisher = "SAGE Publications Inc.",
number = "6",

}

TY - JOUR

T1 - The Safety and Feasibility of Admitting Patients With Intracerebral Hemorrhage to the Step-Down Unit

AU - Hafeez, Shaheryar

AU - Behrouz, Reza

PY - 2016/7/1

Y1 - 2016/7/1

N2 - BACKGROUND: Intracerebral hemorrhage (ICH) is a devastating and costly condition. Although the American Heart Association/American Stroke Association recommends admitting patients with ICH to a neurocritical care unit (NCCU), this strategy may accrue unnecessary cost for patients with relatively milder presentation. We conducted a prospective observational study to determine the safety and feasibility of admitting patients with mild ICH directly to a step-down unit (SDU) instead of an NCCU.METHODS: Consecutive patients with "mild presentation," defined as a combination of ICH score ≤2, National Institutes of Health Stroke Scale (NIHSS) ≤ 15, and Graeb score ≤2 (if intraventricular hemorrhage was present), were admitted to the SDU. Data were collected on age, gender as well as the initial NIHSS, Glasgow Coma Scale (GCS), ICH, and Graeb scores. Primary end point was any complication or death during hospital stay.RESULTS: Twenty patients were admitted to the SDU. No patient was transferred to the NCCU from the SDU. One patient, who eventually died, had respiratory insufficiency due to hospital-acquired pneumonia.CONCLUSION: Admission of ICH patients with mild symptoms to the SDU is safe and feasible. Larger prospective studies are needed to define the specific criteria for admission.

AB - BACKGROUND: Intracerebral hemorrhage (ICH) is a devastating and costly condition. Although the American Heart Association/American Stroke Association recommends admitting patients with ICH to a neurocritical care unit (NCCU), this strategy may accrue unnecessary cost for patients with relatively milder presentation. We conducted a prospective observational study to determine the safety and feasibility of admitting patients with mild ICH directly to a step-down unit (SDU) instead of an NCCU.METHODS: Consecutive patients with "mild presentation," defined as a combination of ICH score ≤2, National Institutes of Health Stroke Scale (NIHSS) ≤ 15, and Graeb score ≤2 (if intraventricular hemorrhage was present), were admitted to the SDU. Data were collected on age, gender as well as the initial NIHSS, Glasgow Coma Scale (GCS), ICH, and Graeb scores. Primary end point was any complication or death during hospital stay.RESULTS: Twenty patients were admitted to the SDU. No patient was transferred to the NCCU from the SDU. One patient, who eventually died, had respiratory insufficiency due to hospital-acquired pneumonia.CONCLUSION: Admission of ICH patients with mild symptoms to the SDU is safe and feasible. Larger prospective studies are needed to define the specific criteria for admission.

KW - acute stroke management

KW - critical care

KW - intracerebral hemorrhage

UR - http://www.scopus.com/inward/record.url?scp=85002604288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85002604288&partnerID=8YFLogxK

U2 - 10.1177/0885066615578113

DO - 10.1177/0885066615578113

M3 - Article

C2 - 25818620

AN - SCOPUS:85002604288

VL - 31

SP - 409

EP - 411

JO - Journal of Intensive Care Medicine

JF - Journal of Intensive Care Medicine

SN - 0885-0666

IS - 6

ER -