Department of Neurosurgery, University Hospital, Goethe University, Frankfurt am Main, Germany.
Institute of Neuroradiology, University Hospital, Goethe University, Frankfurt am Main, Germany.
Sci Rep. 2021 Apr 15;11(1):8309. doi: 10.1038/s41598-021-87863-y.
Patient care in a neurointensive care unit (neuro-ICU) is challenging. Multidrug-resistant organisms (MDROs) are increasingly common in the routine clinical practice. We evaluated the impact of infection with MDROs on outcomes in patients with subarachnoid hemorrhage (SAH). A single-center retrospective analysis of SAH cases involving patients treated in the neuro-ICU was performed. The outcome was assessed 6 months after SAH using the modified Rankin Scale [mRS, favorable (0-2) and unfavorable (3-6)]. Data were compared by matched-pair analysis. Patient characteristics were well matched in the MDRO (n = 61) and control (n = 61) groups. In this center, one nurse was assigned to a two-bed room. If a MDRO was detected, the patient was isolated, and the nurse was assigned to the patient infected with the MDRO. In the MDRO group, 29 patients (48%) had a favorable outcome, while 25 patients (41%) in the control group had a favorable outcome; the difference was not significant (p > 0.05). Independent prognostic factors for unfavorable outcomes were worse status at admission (OR = 3.1), concomitant intracerebral hematoma (ICH) (OR = 3.7), and delayed cerebral ischemia (DCI) (OR = 6.8). Infection with MRDOs did not have a negative impact on the outcome in SAH patients. Slightly better outcomes were observed in SAH patients infected with MDROs, suggesting the benefit of individual care.
神经重症监护病房(Neuro-ICU)的患者护理具有挑战性。多药耐药菌(MDROs)在常规临床实践中越来越常见。我们评估了 MDRO 感染对蛛网膜下腔出血(SAH)患者结局的影响。对Neuro-ICU 治疗的 SAH 病例进行了单中心回顾性分析。使用改良Rankin 量表(mRS,有利(0-2)和不利(3-6))在 SAH 后 6 个月评估结局。通过配对分析比较数据。MDRO(n=61)和对照组(n=61)患者的特征在匹配组中匹配良好。在该中心,一名护士负责两个床位的病房。如果检测到 MDRO,患者将被隔离,护士将被分配到感染 MDRO 的患者。在 MDRO 组中,29 名患者(48%)结局良好,而对照组 25 名患者(41%)结局良好;差异无统计学意义(p>0.05)。不良结局的独立预后因素为入院时状态较差(OR=3.1)、伴发脑内血肿(ICH)(OR=3.7)和迟发性脑缺血(DCI)(OR=6.8)。MDRO 感染对 SAH 患者的结局没有负面影响。感染 MDRO 的 SAH 患者的结局略好,表明个体化护理有益。