title: Impact of a dedicated neurocritical care team in treating patients with aneurysmal subarachnoid hemorrhage.
abstract: BACKGROUND
  Intensivist staffing of intensive care units (ICUs) has been associated with a reduction in in-hospital mortality. These improvements in patient outcomes have been extended to neurointensivist staffing of neuroscience ICUs for patients with intracranial hemorrhage and traumatic brain injury.
  
  
  OBJECTIVE
  The primary objective of this study is to determine if hospital outcomes (measured by discharge status) for patients admitted with aneurysmal subarachnoid hemorrhage changed after the introduction of a neurointensivist-led multidisciplinary neurocritical care team.
  
  
  METHODS
  The authors retrospectively identified 703 patients admitted to the neuroscience ICU with a diagnosis of aneurysmal subarachnoid hemorrhage at a single academic tertiary care hospital between January 1, 1995 and December 31, 2002. It was compared with discharge outcomes for those patients treated prior to and following the development of a multidisciplinary neurocritical care team.
  
  
  RESULTS
  Patients treated after the introduction of a neurocritical care team were significantly more likely to be discharged to home (25.2% vs. 36.5%) and less likely to be discharged to a rehab facility (25.2% vs. 36.5%). Patients treated after introduction of a neurocritical care team were also more likely to receive definitive aneurysm treatment (10.9% vs. 18%).
  
  
  CONCLUSIONS
  The implementation of a neurointensivist-led neurocritical care team is associated with improved hospital discharge disposition for patients with aneurysmal subarachnoid hemorrhage.
authors.affiliation: Department of Neurosurgery, Emory University School of Medicine, 1365 Clifton Road NE, Atlanta, GA 30322, USA. obsamue@emory.edu
authors.forename: Owen
authors.initials: O
authors.lastname: Samuels
authors.forename: Adam
authors.initials: A
authors.lastname: Webb
authors.forename: Steve
authors.initials: S
authors.lastname: Culler
authors.forename: Kathleen
authors.initials: K
authors.lastname: Martin
authors.forename: Daniel
authors.initials: D
authors.lastname: Barrow
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000328:Adult; D015897:Comorbidity; D003422:Critical Care / Q000458:organization & administration*; D004185:Disability Evaluation; D005260:Female; D005845:Georgia; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D002532:Intracranial Aneurysm / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration*; D010351:Patient Discharge / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012189:Retrospective Studies; D020379:Risk Adjustment; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D013345:Subarachnoid Hemorrhage / Q000401:mortality* / Q000628:therapy*