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  • Vasospasm Onset after SAH: Outcome Analysis and Implications for Patient Care

    Final Number:
    1110

    Authors:
    Dinesh Ramanathan MD MS MPH; Sujith MD Bhimireddy; Kenneth Fraser MD; Jeffrey Klopfenstein MD

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Vasospasm following aneurysmal Subarachnoid Hemorrhage (SAH) is an important determinant for patient care following definitive treatment of aneurysm. It is critical to understand the temporal trend in incidence of vasospasm and safety of early patient disposition from intensive care settings with early weaning of external ventricular drain in patients who do not develop early vasospasm.

    Methods: A retrospective review of all patients treated was performed after IRB approval. Information collected with chart review included patient demographics, treatment particulars including angiograms, vasospasm, disposition and clinical outcomes.

    Results: A total of 347 patients were treated at over a period of five years. Of this group, 22 patients had no evidence of vasospasm in day 7 angiogram, of which only two patients demonstrated mild vasospasm in subsequent angiogram. Early weaning of external ventricular drain was performed in this patient group with early disposition from intensive care setting and no significant adverse event/outcome was noted due to this practice.

    Conclusions: A subset of SAH patients who do not develop vasospasm by day 7 can safely be managed aggressively with disposition from intensive care setting. The incidence of late vasospasm is uncommon. This indicates significant cost savings in care of SAH patients while providing optimal care.

    Patient Care: Optimize length of hospital stay for patients with SAH thereby decreasing cost of care. Potentially decrease hospital stay associated postoperative complications

    Learning Objectives: Recognize the temporal trends of SAH onset and manage patients accordingly Recognise the safety and advantages of early disposition of subset of SAH patients who do not develop vasospasm.

    References:

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