Key result
Selective floor triage after elective aneurysm treatment is associated with similar 30-day morbidity versus ICU.
Why the study?
Routine intensive care unit monitoring is common after elective embolization of unruptured intracranial aneurysms, but the necessity of this practice is unclear.
Does triage to routine floor care safely prevent unnecessary ICU admissions in patients undergoing elective embolization of unruptured intracranial aneurysms without major co-morbidities or complications?
Observational (n=178)
No
Does triage to routine floor care safely prevent unnecessary ICU admissions in patients undergoing elective embolization of unruptured intracranial aneurysms without major co-morbidities or complications?
Absolute Event Rate: 0.8% vs 1.9%
p-value: p=0.563
Patients undergoing elective embolization of unruptured intracranial aneurysms without major co-morbidities or complex morphology can be safely observed in a regular ward, avoiding routine ICU admission.
Supports selective floor care in low-risk elective unruptured aneurysm embolization; hypothesis-generating and requires prospective validation.
SUMMARY: Routine intensive care unit monitoring is common after elective embolization of unruptured intracranial aneurysms. In this series of 200 consecutive endovascular procedures for unruptured intracranial aneurysms, 65% of patients were triaged to routine (non-intensive care unit) floor care based on intraoperative findings, aneurysm morphology, and absence of major co-morbidities. Only 1 patient (0.5%) required subsequent transfer to the intensive care unit for management of a perioperative complication. The authors conclude that patients without major co-morbidities, intraoperative complications, or complex aneurysm morphology can be safely observed in a regular ward rather than being admitted to the intensive care unit.
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Burrows et al. (2013) conducted an observational in Unruptured intracranial aneurysms (n=178). Routine floor care vs. Intensive care unit (ICU) admission was evaluated on 30-day morbidity (p=0.563). Selective triage to routine floor care after elective endovascular treatment of unruptured aneurysms resulted in a 30-day morbidity rate of 0.8%, which was not significantly different from the 1.9% rate in patients admitted to the ICU (p=0.563).
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