A step-down unit transfer protocol for low-risk aneurysmal subarachnoid hemorrhage

Neurosurgical Focus
Alexander G ChartrainErrol Gordon

Abstract

OBJECTIVE Patients who have experienced subarachnoid hemorrhage (SAH) often receive care in the setting of the ICU. However, SAH patients may not all require extended ICU admission. The authors established a protocol on January 1, 2015, to transfer select, low-risk patients to a step-down unit (SDU) to streamline care for SAH patients. This study describes the results of the implemented protocol. METHODS In this retrospective chart review, patients presenting with SAH between January 2011 and September 2016 were reviewed for inclusion. The control group consisted of patients admitted prior to establishment of the SDU transfer protocol, while the intervention group consisted of patients admitted afterward. RESULTS Of the patients in the intervention group, 79.2% (57/72) were transferred to the SDU during their admission. Of these transferred patients, 29.8% (17/57) required return to the neurosurgical ICU (NSICU). There were no instances of morbidity or mortality directly related to care in the SDU. Patients in the intervention group had a mean reduced NSICU length of stay, by 1.95 days, which trended toward significance, and a longer average hospitalization, by 2.7 days, which also trended toward significance. In-hospital morta...Continue Reading

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Citations

Nov 2, 2017·Neurosurgical Focus·Joshua E Medow
Apr 27, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Rima M DaferJose Biller
Sep 23, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·L LlullÁ Chamorro
Jun 17, 2020·Mayo Clinic Proceedings. Innovations, Quality & Outcomes·Christina I CollinsWilliam D Freeman
Feb 1, 2022·Neurocritical Care·Patrick D KellyRohan V Chitale

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