Admission to a neurologic/neurosurgical intensive care unit is associated with reduced mortality rate after intracerebral hemorrhage

Abstract

For patients with acute ICH, admission to a neuro vs. general ICU is associated with reduced mortality rate.

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

“…[25][26][27] Several observational studies have suggested that an organized, protocol-based approach with emphasis on the prevention of ''secondary'' neurological insults may be associated with improved recovery. [28][29][30][31][32][33][34] Consistent with these developments, the care of neurocritical care patients in our region of Canada has evolved considerably over the past decade. There are few contemporary data assessing whether outcomes have changed.…”

Brief review: Practice variation in end of life care in the ICU: implications for patients with severe brain injury

“…27 These investigators also found that neurologists and neurosurgeons differed in the intensity with which they approached the same type of clinical problem within one institution, again highlighting the variable care that patients may receive according to where and by whom they are cared for. 27 Others have found influences on outcome according to whether patients are admitted to a general or to a neurosurgical ICU 28 or whether surgical intervention is early or delayed, 29 in the use of induced hypothermia, seizure medications, paralytic agents, 30 use of intracranial monitoring, 30,31 or according to physician prediction of severely impaired future cognitive function. 32 …”

Therapeutic Strategies in Acute Intracerebral Hemorrhage

“…However, specialized treatment of acute ICH in a neurology or neurosurgery intensive care unit may well improve outcomes [52]. In addition, the fact that patients who have their care limited (such as those who have a "do not resuscitate" order) show worse outcomes, even in the absence of cardiac arrest, suggests that comprehensive aggressive care does provide some benefit [53].…”