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01.09.2016 | original article | Ausgabe 17-18/2016

Wiener klinische Wochenschrift 17-18/2016

Current practice in neurocritical care of patients with subarachnoid haemorrhage and severe traumatic brain injury

Results of the Austrian Neurosurvey Study

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 17-18/2016
Autoren:
M.D. Günther Herzer, Ph.D. M.D. Udo Illievich, M.D. Wolfgang G. Voelckel, M.D. Helmut Trimmel
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi: 10.​1007/​s00508-016-1027-4) contains supplementary material, which is available to authorized users.

Summary

Objectives

The task force Neuroanaesthesia of the Austrian Society of Anaesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) is aiming to develop and provide recommendations in order to improve neurocritical care in Austria. Thus, a survey on neurocritical care concepts in Austria regarding intensive care of subarachnoid haemorrhage (SAH) and severe traumatic brain injury (TBI) was performed to assess the current status.

Methods

An online internet questionnaire comprising 59 items on current concepts of SAH and TBI critical care was sent to 117 anaesthesiology departments.

Results

The survey was answered by 30 (25.6 %) of the hospitals, 24 (80 %) of them treating patients with SAH and/or TBI. Data from ten SAH centres reveal that definitive care was achieved within 24 h in all hospitals; a case load >50 per year is noted in 70 % of intensive care units (ICU). In all, 50 % of departments employ written protocols for treatment. Regarding the treatment of TBI patients, 14 answers were received, indicating that 42.9 % of departments provide care for >50 patients per year. Time between arrival and CT scan is <30 min in all hospitals, and 28.6 % of departments rely on written protocols. Only 14.3 % of hospitals report about routine morbidity and mortality rounds. While the neurologic status is assessed at discharge from the ICU, there is no evaluation of 1‑year outcome.

Conclusions

Definitive care of SAH and TBI patients is achieved timely in Austria. When compared with SAH, more hospitals with lower case loads take care of TBI patients. Written guidelines and protocols at institutional level are often missing. Since routine morbidity and mortality conferences are sparse, and long-term outcome is not assessed, there is room for improvement.

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Zusatzmaterial
Austrian Neuro ICU Survey
508_2016_1027_MOESM1_ESM.pdf
Literatur
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