Patients with aneurysmal subarachnoid haemorrhage treated in Swedish intensive care: A registry study

Author:

Anna Arnlind12ORCID,Marita Danielsson23,Lars Engerström45ORCID,Lovisa Tobieson12,Lotti Orwelius26

Affiliation:

1. Department of Neurosurgery in Linköping University Hospital Linköping Sweden

2. Department of Biomedical and Clinical Sciences Linköping University Linköping Sweden

3. The Swedish National Patient Insurance Company (Löf) Stockholm Sweden

4. Department of Anaesthesiology and Intensive Care Vrinnevi Hospital Norrköping Sweden

5. Department of Thoracic and Vascular Surgery and Department of Medical and Health Sciences Linköping University Linköping Sweden

6. Department of Anaesthesiology and Intensive Care University Hospital Linköping Sweden

Abstract

AbstractBackgroundAneurysmal subarachnoid haemorrhage (aSAH) is a life‐threatening disease with high mortality and morbidity. Patients with aSAH in Sweden are cared for at one of six neuro intensive care units (NICU) or at a general intensive care unit (ICU).This study aimed to describe the incidence, length of stay, time in ventilator and mortality for these patients.MethodsThis is a retrospective, descriptive study of patients with aSAH, registered in the Swedish Intensive care Registry between 2017 and 2019. The cohort was divided in sub‐cohorts (NICU and general ICU) and regions. Mortality was analysed with logistic regression.ResultsA total of 1520 patients with aSAH from five regions were included in the study. Mean age of the patients were 60.6 years and 58% were female. Mortality within 180 days of admission was 30% (n = 456) of which 17% (n = 258) died during intensive care.A majority of the patients were treated at one hospital and in one ICU (70%, n = 1062). More than half of the patients (59%, n = 897) had their first intensive care admission at a hospital with a NICU.Patients in the North region had the lowest median GCS (10) and the highest SAPS3 score (60) when admitted to NICU. Treatment with invasive mechanical ventilation differed significantly between regions; 91% (n = 80) in the region with highest proportion versus 56% (n = 94) in the region with the lowest proportion, as did mortality; 16% (n = 44) versus 8% (n = 23). No differences between regions were found regarding age, sex and length of stay.ConclusionsPatients with aSAH treated in a NICU or in an ICU in Sweden differs in characteristics. The study further showed some differences between regions which might be reduced if there were national consensus and treatment guidelines implemented.

Publisher

Wiley

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