naa a22 4500 510800114 CHVBK 20180411083351.0 cr unu---uuuuu 180411e20130601xx s 000 0 eng 10.1007/s12028-013-9815-4 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9815-4 Early Predictors of Prolonged Stay in a Critical Care Unit Following Aneurysmal Subarachnoid Hemorrhage [Elektronische Daten] [Christopher Witiw, George Ibrahim, Aria Fallah, R. Macdonald] Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a neurologic emergency that typically warrants initial monitoring in a critical care setting. The aim of this study is to identify clinical and radiologic features on admission that predict a protracted critical care admission following aSAH. Methods: Exploratory posthoc analysis was performed on the 413 patients enrolled in Clazosentan to Overcome Neurological iSChemia and Infarction OccUrring after Subarachnoid hemorrhage (CONSCIOUS-1), a prospective randomized control trial of clazosentan for the prevention of vasospasm after aSAH. The association between potential clinical and radiographic covariates, and the length of stay (LOS) in a critical care unit after aSAH was determined using a Cox proportional hazards model. Covariates with a significance level of p<0.20, on univariate analysis, were entered into a multivariate forward conditional analysis to identify independent predictors of prolonged LOS. Results: The mean LOS was 12.6±10.6days. On multivariate analysis, age (hazard ratio [HR] 1.01, 95% confidence interval [CI] 1.00-1.02; p=0.032), a history of hypertension (HR 1.30, CI 1.01-1.67; p=0.045), and a World Federation of Neurosurgical Societies Score of IV-V on admission (HR 1.38, CI 1.05-1.81; p=0.02) were the clinical features associated with a greater critical care LOS following aSAH. Intracerebral hemorrhage (HR 1.50, CI 1.03-2.21; p=0.004) and increasing intraventricular clot burden (HR 1.08, CI 1.03-1.14; p=0.037) on admission computed tomography were the radiologic features associated with prolonged LOS. Conclusions: We have identified several early risk factors associated with a prolonged critical care stay following aSAH. Springer Science+Business Media New York, 2013 Critical care nationallicence Intensive care unit nationallicence Intracranial aneurysm nationallicence Length of stay nationallicence Stroke nationallicence Subarachnoid hemorrhage nationallicence Witiw Christopher Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut Ibrahim George Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut Fallah Aria Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut Macdonald R. Division of Neurosurgery, St. Michael's Hospital, University of Toronto, 30 Bond Street, M5B 1W8, Toronto, ON, Canada aut Neurocritical Care Humana Press Inc 18/3(2013-06-01), 291-297 1541-6933 18:3<291 2013 18 12028 https://doi.org/10.1007/s12028-013-9815-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9815-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Witiw Christopher Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Ibrahim George Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Fallah Aria Division of Neurosurgery, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Macdonald R. Division of Neurosurgery, St. Michael's Hospital, University of Toronto, 30 Bond Street, M5B 1W8, Toronto, ON, Canada aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/3(2013-06-01), 291-297 1541-6933 18:3<291 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer