Title: Abstract TP37: Border Hospital With Predominantly Hispanic Population Significantly Improves Outcomes in Subarachnoid Hemorrhage Patients After Implementation of Endovascular and Neurocritical Care Services
Abstract: Background: Although comprehensive 24/7 endovascular capability and neurocritical care have been effective in the treatment of Subarachnoid Hemorrhage (SAH), studies have shown that there exists a historically significant disparity in providing access to such care within border Hispanic populations. As such, the efficacy of endovascular and neurocritical care within such populations groups has not been thoroughly investigated, particularly for SAH treatment. Objective: To evaluate the differences in outcomes before and after the implementation of comprehensive neurocritical care upon an SAH patient population comprised primarily of hispanics within border states. Methods: SAH patient data was collected before (2008 - August 2012) and after (September 2012 - 2018) the establishment of comprehensive 24/7 endovascular and neurocritical care services at the hospital. Data collected from both groups included demographic information, glascow coma scale scores, comorbidities, rates of functional independence (modified Rankin scale (mRS) 0-2), and dispositions. Univariate analyses were conducted. Results: Hispanics constituted 322 (89.4%) of 360 SAH patients and 265 (82.2%) of those who underwent comprehensive neurocritical care. The collected demographic variables and premorbidity rates were not found to be significantly different between the ‘before’ and ‘after’ groups. Patients treated with comprehensive neurocritical care were found to have higher rates of home dispositions (44.9% vs. 30.9%, p = 0.035) as well as lower rates of death dispositions (26.7% vs. 44.2%, p = 0.0048) compared to patients without neurocritical care. Conclusion: SAH patients with access to comprehensive neurocritical care had lower mortality rates and higher home dispositions compared to those who did not have such access. Larger prospective studies are needed in order to demonstrate the efficacy of endovascular and comprehensive neurocritical care in treating SAH.
Publication Year: 2019
Publication Date: 2019-02-01
Language: en
Type: article
Indexed In: ['crossref']
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