Discharge criteria from intensive care unit in brain injured patients

Maurizio Berardino, O. Morrone, P. F. Sciacca, R. Rosato, G. Ciccone, F. Massaro, Andrew Maas, Nino Stocchetti

Research output: Contribution to journalArticle

Abstract

Objective. We investigated the value of information on clinical features and intensity of treatment activity in the Intensive Care Unit (ICU) in predicting the need for further interventions after a patient is discharged from the Intensive Care Unit. Our aim was to assess if this could aid in making decisions about transfer to an Immediate Care Unit (sub-ICU). Methods. We studied 39 patients with acute brain damage (traumatic or vascular causes). They ranged in age from 15 to 75 years and none had an associated spinal cord injury. The SAPS II, Glasgow Coma Scale (GCS), length of stay in ICU, duration of hospital stay and daily NEMS scores were recorded for each patient. We recorded the activities performed after transfer to an sICU, including complications that required active "life-saving" treatment. The role of each factor was assessed by using the odds ratio (OR), and with linear logistic regression. Findings. 8 of the 39 patients developed a complication in the Sub-ICU. A linear logistic regression analysis demonstrated that the principal features having significant predictive value were: a) age, with an increase in risk of over 10 times for patients that were older than 50 (p= 0.011); b) SAPS II scores ≥50 points, with 24 times an increase in risk (p = 0.002); and c) a GCS score ≤5 points, with an increase in risk of almost 7 times (p = 0.024). Interpretation. Complications in Sub-ICU are less likely in patients younger than 50 and who have SAPS II and GCS scores within predetermined limits. These indices can help in making decisions about discharge of a patient from ICU to Sub-ICU.

Original languageEnglish
Pages (from-to)453-456
Number of pages4
JournalActa Neurochirurgica
Volume146
Issue number5
DOIs
Publication statusPublished - May 2004

Fingerprint

Intensive Care Units
Brain
Glasgow Coma Scale
Linear Models
Length of Stay
Decision Making
Logistic Models
Spinal Cord Injuries
Blood Vessels
Patient Care
Odds Ratio
Regression Analysis
Therapeutics
Simplified Acute Physiology Score

Keywords

  • Intermediate care unit
  • Neurosurgery intensive care discharge
  • Resource allocation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Berardino, M., Morrone, O., Sciacca, P. F., Rosato, R., Ciccone, G., Massaro, F., ... Stocchetti, N. (2004). Discharge criteria from intensive care unit in brain injured patients. Acta Neurochirurgica, 146(5), 453-456. https://doi.org/10.1007/s00701-003-0176-1

Discharge criteria from intensive care unit in brain injured patients. / Berardino, Maurizio; Morrone, O.; Sciacca, P. F.; Rosato, R.; Ciccone, G.; Massaro, F.; Maas, Andrew; Stocchetti, Nino.

In: Acta Neurochirurgica, Vol. 146, No. 5, 05.2004, p. 453-456.

Research output: Contribution to journalArticle

Berardino, M, Morrone, O, Sciacca, PF, Rosato, R, Ciccone, G, Massaro, F, Maas, A & Stocchetti, N 2004, 'Discharge criteria from intensive care unit in brain injured patients', Acta Neurochirurgica, vol. 146, no. 5, pp. 453-456. https://doi.org/10.1007/s00701-003-0176-1
Berardino M, Morrone O, Sciacca PF, Rosato R, Ciccone G, Massaro F et al. Discharge criteria from intensive care unit in brain injured patients. Acta Neurochirurgica. 2004 May;146(5):453-456. https://doi.org/10.1007/s00701-003-0176-1
Berardino, Maurizio ; Morrone, O. ; Sciacca, P. F. ; Rosato, R. ; Ciccone, G. ; Massaro, F. ; Maas, Andrew ; Stocchetti, Nino. / Discharge criteria from intensive care unit in brain injured patients. In: Acta Neurochirurgica. 2004 ; Vol. 146, No. 5. pp. 453-456.
@article{613e9a9f9eb04cd89aef3bc030516045,
title = "Discharge criteria from intensive care unit in brain injured patients",
abstract = "Objective. We investigated the value of information on clinical features and intensity of treatment activity in the Intensive Care Unit (ICU) in predicting the need for further interventions after a patient is discharged from the Intensive Care Unit. Our aim was to assess if this could aid in making decisions about transfer to an Immediate Care Unit (sub-ICU). Methods. We studied 39 patients with acute brain damage (traumatic or vascular causes). They ranged in age from 15 to 75 years and none had an associated spinal cord injury. The SAPS II, Glasgow Coma Scale (GCS), length of stay in ICU, duration of hospital stay and daily NEMS scores were recorded for each patient. We recorded the activities performed after transfer to an sICU, including complications that required active {"}life-saving{"} treatment. The role of each factor was assessed by using the odds ratio (OR), and with linear logistic regression. Findings. 8 of the 39 patients developed a complication in the Sub-ICU. A linear logistic regression analysis demonstrated that the principal features having significant predictive value were: a) age, with an increase in risk of over 10 times for patients that were older than 50 (p= 0.011); b) SAPS II scores ≥50 points, with 24 times an increase in risk (p = 0.002); and c) a GCS score ≤5 points, with an increase in risk of almost 7 times (p = 0.024). Interpretation. Complications in Sub-ICU are less likely in patients younger than 50 and who have SAPS II and GCS scores within predetermined limits. These indices can help in making decisions about discharge of a patient from ICU to Sub-ICU.",
keywords = "Intermediate care unit, Neurosurgery intensive care discharge, Resource allocation",
author = "Maurizio Berardino and O. Morrone and Sciacca, {P. F.} and R. Rosato and G. Ciccone and F. Massaro and Andrew Maas and Nino Stocchetti",
year = "2004",
month = "5",
doi = "10.1007/s00701-003-0176-1",
language = "English",
volume = "146",
pages = "453--456",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "5",

}

TY - JOUR

T1 - Discharge criteria from intensive care unit in brain injured patients

AU - Berardino, Maurizio

AU - Morrone, O.

AU - Sciacca, P. F.

AU - Rosato, R.

AU - Ciccone, G.

AU - Massaro, F.

AU - Maas, Andrew

AU - Stocchetti, Nino

PY - 2004/5

Y1 - 2004/5

N2 - Objective. We investigated the value of information on clinical features and intensity of treatment activity in the Intensive Care Unit (ICU) in predicting the need for further interventions after a patient is discharged from the Intensive Care Unit. Our aim was to assess if this could aid in making decisions about transfer to an Immediate Care Unit (sub-ICU). Methods. We studied 39 patients with acute brain damage (traumatic or vascular causes). They ranged in age from 15 to 75 years and none had an associated spinal cord injury. The SAPS II, Glasgow Coma Scale (GCS), length of stay in ICU, duration of hospital stay and daily NEMS scores were recorded for each patient. We recorded the activities performed after transfer to an sICU, including complications that required active "life-saving" treatment. The role of each factor was assessed by using the odds ratio (OR), and with linear logistic regression. Findings. 8 of the 39 patients developed a complication in the Sub-ICU. A linear logistic regression analysis demonstrated that the principal features having significant predictive value were: a) age, with an increase in risk of over 10 times for patients that were older than 50 (p= 0.011); b) SAPS II scores ≥50 points, with 24 times an increase in risk (p = 0.002); and c) a GCS score ≤5 points, with an increase in risk of almost 7 times (p = 0.024). Interpretation. Complications in Sub-ICU are less likely in patients younger than 50 and who have SAPS II and GCS scores within predetermined limits. These indices can help in making decisions about discharge of a patient from ICU to Sub-ICU.

AB - Objective. We investigated the value of information on clinical features and intensity of treatment activity in the Intensive Care Unit (ICU) in predicting the need for further interventions after a patient is discharged from the Intensive Care Unit. Our aim was to assess if this could aid in making decisions about transfer to an Immediate Care Unit (sub-ICU). Methods. We studied 39 patients with acute brain damage (traumatic or vascular causes). They ranged in age from 15 to 75 years and none had an associated spinal cord injury. The SAPS II, Glasgow Coma Scale (GCS), length of stay in ICU, duration of hospital stay and daily NEMS scores were recorded for each patient. We recorded the activities performed after transfer to an sICU, including complications that required active "life-saving" treatment. The role of each factor was assessed by using the odds ratio (OR), and with linear logistic regression. Findings. 8 of the 39 patients developed a complication in the Sub-ICU. A linear logistic regression analysis demonstrated that the principal features having significant predictive value were: a) age, with an increase in risk of over 10 times for patients that were older than 50 (p= 0.011); b) SAPS II scores ≥50 points, with 24 times an increase in risk (p = 0.002); and c) a GCS score ≤5 points, with an increase in risk of almost 7 times (p = 0.024). Interpretation. Complications in Sub-ICU are less likely in patients younger than 50 and who have SAPS II and GCS scores within predetermined limits. These indices can help in making decisions about discharge of a patient from ICU to Sub-ICU.

KW - Intermediate care unit

KW - Neurosurgery intensive care discharge

KW - Resource allocation

UR - http://www.scopus.com/inward/record.url?scp=2442635008&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2442635008&partnerID=8YFLogxK

U2 - 10.1007/s00701-003-0176-1

DO - 10.1007/s00701-003-0176-1

M3 - Article

C2 - 15118881

AN - SCOPUS:2442635008

VL - 146

SP - 453

EP - 456

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 5

ER -