Resource Utilization for Patients with Intracerebral Hemorrhage Transferred to a Comprehensive Stroke Center.
Publication/Presentation Date
12-1-2015
Abstract
BACKGROUND: As a comprehensive stroke center (CSC), we accept transfer patients with intracerebral hemorrhage (ICH) in our region. CSC guidelines mandate receipt of patients with ICH for higher level of care. We determined resource utilization of patients accepted from outside hospitals compared with patients directly arriving to our center.
METHODS: From our stroke registry, we compared patients with primary ICH transferred to those directly arriving to our CSC from March 2011-March 2012. We compared the proportion of patients who utilized at least one of these resources: neurointensive care unit (NICU), neurosurgical intervention, or clinical trial enrollment.
RESULTS: Among the 362 patients, 210 (58%) were transfers. Transferred patients were older, had higher median Glasgow Coma Scale scores, and lower National Institutes of Health Stroke Scale scores than directly admitted patients. Transfers had smaller median ICH volumes (20.5 cc versus 15.2 cc; P = .04) and lower ICH scores (2.1 ± 1.4 versus 1.6 ± 1.3; P < .01). A smaller proportion of transfers utilized CSC-specific resources compared with direct admits (P = .02). Fewer transferred patients required neurosurgical intervention or were enrolled in trials. No significant difference was found in the proportion of patients who used NICU resources, although transferred patients had a significantly lower length of stay in the NICU. Average hospital stay costs were less for transferred patients than for direct admits.
CONCLUSIONS: Patients with ICH transferred to our CSC underwent fewer neurosurgical procedures and had a shorter stay in the NICU. These results were reflected in the lower per-patient costs in the transferred group. Our results raise the need to analyze cost-benefits and resource utilization of transferring patients with milder ICH.
Volume
24
Issue
12
First Page
2866
Last Page
2874
ISSN
1532-8511
Published In/Presented At
Nguyen, C., Mir, O., Vahidy, F., Wu, T. C., Albright, K., Boehme, A., Delgado, R., & Savitz, S. (2015). Resource Utilization for Patients with Intracerebral Hemorrhage Transferred to a Comprehensive Stroke Center. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 24(12), 2866–2874. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.08.023
Disciplines
Medicine and Health Sciences
PubMedID
26460244
Department(s)
Department of Medicine
Document Type
Article