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Does the subspecialty of an intensive care unit (ICU) has an impact on outcome in patients suffering from aneurysmal subarachnoid hemorrhage?

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Abstract

We retrospectively compared the outcome of aneurysmal subarachnoid hemorrhage (aSAH) patients treated in a neurosurgical ICU (nICU) between 1990 and 2005 with that of patients treated in a general ICU (gICU) between 2005 and 2013 with almost identical treatment strategies. Among other parameters, we registered the initial Hunt and Hess grade, Fisher score, the incidence of vasospasm, and outcome. A multivariate analysis (logistic regression model) was performed to adjust for different variables. In total, 755 patients were included in this study with 456 patients assigned to the nICU and 299 patients to the gICU. Multivariate logistic regression analysis revealed no significant difference between the patient outcome treated in a nICU versus gICU after adjusting for different variables. The outcome of patients after aSAH is not influenced by the type of ICU (gICU versus nICU). The data do not allow claiming that aSAH patients need to be treated in a specialized ICU for obtaining better results. Parameters which might differ from hospital to hospital, especially warranty of neurosurgical expertise on gICU, have the potential to influence the results.

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Author notes

  1. Dorothee Mielke and Vesna Malinova contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Georg-August-University Göttingen, Göttingen, Germany

    Dorothee Mielke, Vesna Malinova, Patricia Suntheim, Martin Voit & Veit Rohde

  2. Neurochirurgische Klinik, Georg-August-Universität Göttingen, Robert-Koch-Strasse 40, D-37075, Göttingen, Germany

    Dorothee Mielke

  3. Department of Anesthesiology, Georg-August-University Göttingen, Göttingen, Germany

    Onnen Moerer

  4. Department of Neurosurgery, University Hospital RWTH Aachen, Aachen, Germany

    Veit Rohde

Authors
  1. Dorothee Mielke
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  2. Vesna Malinova
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  3. Onnen Moerer
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  4. Patricia Suntheim
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  5. Martin Voit
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  6. Veit Rohde
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Corresponding author

Correspondence to Dorothee Mielke.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was reviewed by the local ethics committee (ethics committee Georg-August-University Göttingen), but did not need approval because it was a retrospective analysis of anonymous data.

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Not needed because of anonymous patient data

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The manuscript is submitted on behalf of all authors and all named authors have participated in this work.

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Mielke, D., Malinova, V., Moerer, O. et al. Does the subspecialty of an intensive care unit (ICU) has an impact on outcome in patients suffering from aneurysmal subarachnoid hemorrhage?. Neurosurg Rev 42, 147–153 (2019). https://doi.org/10.1007/s10143-018-0973-x

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  • DOI: https://doi.org/10.1007/s10143-018-0973-x

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