Association between out-of-hospital emergency department transfer and poor hospital outcome in critically ill stroke patients

Rincón, Fred; Morino, Tricia; Behrens, Danielle; Akbar, Umer; Schorr, Christa; Lee, Elizabeth; Gerber, David; Parrillo, Joseph E.; Mirsen, Thomas R.

doi:10.1016/j.jcrc.2011.02.009

Cited by 18 publications

(11 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These patients were subsequently matched to 268 nonneurological patients. Mean age was 65.6 + 15 years, 46% were men, and median APACHE-II score was [15][16][17][18][19][20]. Within neurological group, there were 53% ICH, 35% AIS, and 12% TBI.…”

Section: Resultsmentioning

confidence: 99%

Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality

Rincón

Patel

Schorr

et al. 2013

J Intensive Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality

Rincón

Patel

Schorr

et al. 2013

J Intensive Care Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Patients who experienced a favorable outcome had higher GCS scores, lower APACHE II scores, lower NIHSS, and longer hospital stays. Although GCS and NIHSS are more traditional metrics, APACHE II scores have been associated with outcomes in critical neurological illness[40]. Differences in hospital length of stay may be explained by higher mortality at an earlier time point in the cohort with an unfavorable outcome, i.e., 50% of subjects with unfavorable outcome died in less than 72 hours from ICH onset.…”

Section: Discussionmentioning

confidence: 99%

Gender and Age Interact to Affect Early Outcome after Intracerebral Hemorrhage

et al. 2013

View full text Add to dashboard Cite

BackgroundIntracerebral hemorrhage (ICH) is a common and devastating form of cerebrovascular disease. In ICH, gender differences in outcomes remain relatively understudied but have been examined in other neurological emergencies. Further, a potential effect of age and gender on outcomes after ICH has not been explored. This study was designed to test the hypothesis that age and gender interact to modify neurological outcomes after ICH.MethodsAdult patients admitted with spontaneous primary supratentorial ICH from July 2007 through April 2010 were assessed via retrospective analysis of an existing stroke database at Duke University. Univariate analysis of collected variables was used to compare gender and outcome. Unfavorable outcome was defined as discharge to hospice or death. Using multivariate regression, the combined effect of age and gender on outcome after ICH was analyzed. ResultsIn this study population, women were younger (61.1+14.5 versus 65.8+17.3 years, p=0.03) and more likely to have a history of substance abuse (35% versus 8.9%, p<0.0001) compared to men. Multivariable models demonstrated that advancing age had a greater effect on predicting discharge outcome in women compared to men (p=0.02). For younger patients, female sex was protective; however, at ages greater than 60 years, female sex was a risk factor for discharge to hospice or death.ConclusionWhile independently associated with discharge to hospice or death after ICH, the interaction effect between gender and age demonstrated significantly stronger correlation with early outcome after ICH in a single center cohort. Prospective study is required to verify these findings.

show abstract

“…In a recent publication by Rincon et al [12], based on a retrospective cohort analysis of 448 patients admitted with either ischemic stroke (34%) or ICH (66%), outside-ED transfer increased the odds of poor outcome two-fold. In multivariate analysis of patients transferred to ICUs, age, APACHE II (Acute Physiology and Chronic Health Evaluation) score greater than 14, GCS score less than 12, do not resuscitate (DNR) status, and outside-ED transfers were independently associated with poor outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Differences in outcomes comparing emergency department (ED) admissions with IHTs have been published in the setting of several critically ill population analyses [8][9][10][11][12][13]. Although in some instances, differences in baseline characteristics have accounted for those differences in outcomes with IHTs likely to represent a more "sick" population [11], in other reviews, the difference in baseline characteristics did not solely account for the difference in outcomes, and the outcomes stood the test of multivariate analysis.…”

Section: Introductionmentioning

confidence: 99%

Impact of pattern of admission on outcomes after aneurysmal subarachnoid hemorrhage

Naval

Chang

Caserta

et al. 2012

Journal of Critical Care

View full text Add to dashboard Cite

Association between out-of-hospital emergency department transfer and poor hospital outcome in critically ill stroke patients

Cited by 18 publications

References 25 publications

Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality

Brain Injury as a Risk Factor for Fever Upon Admission to the Intensive Care Unit and Association With In-Hospital Case Fatality

Gender and Age Interact to Affect Early Outcome after Intracerebral Hemorrhage

Impact of pattern of admission on outcomes after aneurysmal subarachnoid hemorrhage

Contact Info

Product

Resources

About