Neurocritical Care

, Volume 9, Issue 3, pp 287–292

Impact of a Specialized Neurointensive Care Team on Outcomes of Critically Ill Acute Ischemic Stroke Patients

Authors

  • Eric M. Bershad
    • Division of Vascular Neurology and Neurocritical Care, Department of NeurologyBaylor College of Medicine
  • Eliahu S. Feen
    • Division of Neurocritical Care, Department of NeurologySaint Louis University Medical Center
  • Olga H. Hernandez
    • Neurocritical CareInstituto Neurologico de Antioquia
  • M. Fareed K. Suri
    • Endovascular Surgery Neuroradiology Fellow, Department of NeurologyUniversity of Minnesota
    • Division of Vascular Neurology and Neurocritical Care, Department of NeurologyBaylor College of Medicine
Original Paper

DOI: 10.1007/s12028-008-9051-5

Cite this article as:
Bershad, E.M., Feen, E.S., Hernandez, O.H. et al. Neurocrit Care (2008) 9: 287. doi:10.1007/s12028-008-9051-5

Abstract

Background and Purpose

Dedicated stroke units are associated with improved patient outcomes after acute ischemic stroke in general. However, it is unknown whether the population of critically ill ischemic stroke patients admitted to the neurocritical care unit (NCCU) benefit from primary management by a specialized neurocritical care team (NCT). This study is intended to investigate such benefit.

Methods

A retrospective chart review in a large academic university hospital identified 400 patients with acute ischemic stroke admitted to the NCCU, from January 1997 to April 2000, aged 65 ± 14 years. We examined the short- and long-term outcomes of these patients before and after institution of a specialized NCT. We used logistic regression models to determine independent association between outcome and availability of NCT.

Results

The presence of a NCT was associated with a decreased length of NCCU stay (2.9 ± 2.0 vs. 3.7 ± 2.9 days, P < 0.01), decreased length of hospital stay (7.5 ± 4.7 vs. 9.9 ± 7.6, P < 0.001), and increased proportion of home discharges (47% vs. 36%, P < 0.05). The only independent predictor of in-hospital and long-term mortality was the underlying severity of disease as determined by the APACHE III score.

Conclusions

In critically ill acute ischemic stroke patients, institution of a dedicated NCT was associated with a reduction in resource utilization and improved patient outcomes at hospital discharge. Several factors including improved patient care protocols may explain this association.

Keywords

StrokeIschemicICUNeurocritical careOutcomes

Copyright information

© Humana Press Inc. 2008