Abstract：
BACKGROUND: Aneurysmal subarachnoid haemorrhage (aSAH) is a life-threatening disease with high mortality and morbidity. Patients with aSAH in Sweden are cared for at one of six neuro intensive care units (NICU) or at a general intensive care unit (ICU).This study aimed to describe the incidence, length of stay, time in ventilator and mortality for these patients.
METHODS: This is a retrospective, descriptive study of patients with aSAH, registered in the Swedish Intensive care Registry between 2017 and 2019. The cohort was divided in sub-cohorts (NICU and general ICU) and regions. Mortality was analysed with logistic regression.
RESULTS: A total of 1520 patients with aSAH from five regions were included in the study. Mean age of the patients were 60.6 years and 58% were female. Mortality within 180 days of admission was 30% (n = 456) of which 17% (n = 258) died during intensive care. A majority of the patients were treated at one hospital and in one ICU (70%, n = 1062). More than half of the patients (59%, n = 897) had their first intensive care admission at a hospital with a NICU. Patients in the North region had the lowest median GCS (10) and the highest SAPS3 score (60) when admitted to NICU. Treatment with invasive mechanical ventilation differed significantly between regions; 91% (n = 80) in the region with highest proportion versus 56% (n = 94) in the region with the lowest proportion, as did mortality; 16% (n = 44) versus 8% (n = 23). No differences between regions were found regarding age, sex and length of stay.
CONCLUSIONS: Patients with aSAH treated in a NICU or in an ICU in Sweden differs in characteristics. The study further showed some differences between regions which might be reduced if there were national consensus and treatment guidelines implemented.
METHODS: This is a retrospective, descriptive study of patients with aSAH, registered in the Swedish Intensive care Registry between 2017 and 2019. The cohort was divided in sub-cohorts (NICU and general ICU) and regions. Mortality was analysed with logistic regression.
RESULTS: A total of 1520 patients with aSAH from five regions were included in the study. Mean age of the patients were 60.6 years and 58% were female. Mortality within 180 days of admission was 30% (n = 456) of which 17% (n = 258) died during intensive care. A majority of the patients were treated at one hospital and in one ICU (70%, n = 1062). More than half of the patients (59%, n = 897) had their first intensive care admission at a hospital with a NICU. Patients in the North region had the lowest median GCS (10) and the highest SAPS3 score (60) when admitted to NICU. Treatment with invasive mechanical ventilation differed significantly between regions; 91% (n = 80) in the region with highest proportion versus 56% (n = 94) in the region with the lowest proportion, as did mortality; 16% (n = 44) versus 8% (n = 23). No differences between regions were found regarding age, sex and length of stay.
CONCLUSIONS: Patients with aSAH treated in a NICU or in an ICU in Sweden differs in characteristics. The study further showed some differences between regions which might be reduced if there were national consensus and treatment guidelines implemented.
摘要：
背景：动脉瘤性蛛网膜下腔出血（aSAH）是一种致死率和致残率高的危及生命的疾病。瑞典的aSAH患者在六个神经重症监护病房（NICU）之一或普通重症监护病房（ICU）接受护理。这项研究旨在描述发病率，逗留时间,这些患者的呼吸机时间和死亡率。
方法：这是一个回顾性研究，aSAH患者的描述性研究，2017年至2019年在瑞典重症监护登记处注册。该队列分为子队列（NICU和普通ICU）和地区。死亡率采用Logistic回归分析。
结果：共有来自五个地区的1520例aSAH患者纳入研究。患者的平均年龄为60.6岁，58％为女性。入院180天内的死亡率为30％（n=456），其中17％（n=258）在重症监护期间死亡。大多数患者在一家医院和一家ICU接受治疗(70%，n=1062）。超过一半的患者（59%，n=897）在患有NICU的医院进行了首次重症监护。北部地区的患者在入住NICU时，GCS中位数最低（10），SAPS3评分最高（60）。有创机械通气的治疗在地区之间存在显着差异；比例最高的地区为91％（n=80），比例最低的地区为56％（n=94）。死亡率也是如此；16%(n=44)对8%(n=23)。地区之间没有发现年龄差异，性别和逗留时间。
结论：在NICU或瑞典ICU中治疗的aSAH患者的特征不同。该研究进一步表明，如果有全国共识和实施治疗指南，地区之间的一些差异可能会减少。
方法：这是一个回顾性研究，aSAH患者的描述性研究，2017年至2019年在瑞典重症监护登记处注册。该队列分为子队列（NICU和普通ICU）和地区。死亡率采用Logistic回归分析。
结果：共有来自五个地区的1520例aSAH患者纳入研究。患者的平均年龄为60.6岁，58％为女性。入院180天内的死亡率为30％（n=456），其中17％（n=258）在重症监护期间死亡。大多数患者在一家医院和一家ICU接受治疗(70%，n=1062）。超过一半的患者（59%，n=897）在患有NICU的医院进行了首次重症监护。北部地区的患者在入住NICU时，GCS中位数最低（10），SAPS3评分最高（60）。有创机械通气的治疗在地区之间存在显着差异；比例最高的地区为91％（n=80），比例最低的地区为56％（n=94）。死亡率也是如此；16%(n=44)对8%(n=23)。地区之间没有发现年龄差异，性别和逗留时间。
结论：在NICU或瑞典ICU中治疗的aSAH患者的特征不同。该研究进一步表明，如果有全国共识和实施治疗指南，地区之间的一些差异可能会减少。
