Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

For brain hemorrhage, risk of death is lower at high-volume hospitals

24.10.2014

Lower mortality at hospitals with more experience treating subarachnoid hemorrhage, reports neurosurgery

For patients with a severe type of stroke called subarachnoid hemorrhage (SAH), treatment at a hospital that treats a high volume of SAH cases is associated with a lower risk of death, reports a study in the November issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

After adjustment for other factors, the mortality rate after SAH is about one-fifth lower at high-volume hospitals, according to the report by Dr. Shyam Prabhakaran of Northwestern University, Chicago and colleagues. They write, "Our data suggest that experienced centers may provide more optimized care for SAH patients."

Hospital Volume Linked to SAH Mortality

Using data from a nationwide quality improvement program (the Get With the Guidelines-Stroke registry), the researchers identified nearly 32,000 patients with SAH treated at 685 US hospitals between 2003 and 2012. Subarachnoid hemorrhage is a type of stroke in which there is bleeding into the brain, most commonly caused by a ruptured aneurysm.

The study compared mortality rates and other outcomes for patients treated at hospitals with different volumes of SAH patients. The number of SAH cases treated per year ranged from as low as four at the lowest-volume hospitals to 13 or more at the highest-volume hospitals.

The risk of in-hospital death decreased as hospital volume of SAH cases increased: from 29.5 percent at the lowest-volume hospitals to 22.1 percent at the highest-volume hospitals. The difference remained significant after adjustment for differences in patient and hospital characteristics. In that analysis, mortality risk was about one-fifth lower at hospitals with the highest volume of SAH patients, compared to the lowest volume.

Other important SAH outcomes—including the percentage of patients sent directly home from the hospital and the percentage able to walk independently at discharge—were similar between high- and low-volume hospitals. In further analyses, an upper limit of hospital case volume was not identified above which the mortality benefit was not seen; instead, for every 5 cases, there was a 3% relative reduction in mortality.

Findings Add Support for Centralized Stroke Care

Patients treated at high-volume hospitals spent more time in the hospital: median 12 days, compared to five days at low-volume hospitals. This might be an indicator of "more aggressive care including monitoring for complications," Dr. Prabhakaran and coauthors write. However, they note their database did not include information on the specific services and treatments provided.

The results add to previous studies suggesting that hospitals treating a higher volume of patients with SAH may achieve better outcomes. The Get With the Guidelines-Stroke registry provides the opportunity to assess the effects of hospital volume in a large contemporary sample of patients, treated since the introduction of more recent advances in SAH care.

The results show a lower risk of death for SAH patients treated at higher-volume hospitals, independent of patient and other hospital characteristics. Within the limitations of the data, the study adds support to the concept of treating stroke at Comprehensive Stroke Centers—which combine key resources and expertise needed to improve care for complex stroke conditions such as SAH. Dr. Prabhakaran and colleagues conclude, "Our results may have significant implications for regional stroke policies and procedures and affirm the recent recommendations that patients with SAH be treated at high-volume centers."

###

Click here to read "Hospital Case Volume Is Associated With Mortality in Patients Hospitalized With Subarachnoid Hemorrhage."

About Neurosurgery

Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Wolters Kluwer Health

Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America.maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Wolters Kluwer is headquartered in Alphen aan den Rijn, the Netherlands. Its shares are quoted on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).

Follow our official Twitter handle: @WKHealth.

Connie Hughes | Eurek Alert!

Further reports about: Health brain hemorrhage countries hemorrhage mortality neurosurgery risk of death volume

More articles from Studies and Analyses:

nachricht Innovative genetic tests for children with developmental disorders and epilepsy
11.07.2018 | Christian-Albrechts-Universität zu Kiel

nachricht Oxygen loss in the coastal Baltic Sea is “unprecedentedly severe”
05.07.2018 | European Geosciences Union

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Machine-learning predicted a superhard and high-energy-density tungsten nitride

18.07.2018 | Materials Sciences

NYSCF researchers develop novel bioengineering technique for personalized bone grafts

18.07.2018 | Life Sciences

Why might reading make myopic?

18.07.2018 | Health and Medicine

VideoLinks
Science & Research
Overview of more VideoLinks >>>