Comparison of Outcomes Among Neurovascular Patients Managed in Dedicated Neurological Intensive Care Units vs. General Intensive Care Units

Authors

Joanna Roy, Thomas Jefferson UniversityFollow
Basel Musmar, Thomas Jefferson UniversityFollow
Nassos Tziviskos
Saarang Patel
Roberto DeLeon
Ashley Thommana
Shady Mina, Thomas Jefferson UniversityFollow
Stavropoula Tjoumakaris, Thomas Jefferson UniversityFollow
Michael Gooch, Thomas Jefferson UniversityFollow
Robert Rosenwasswer, Thomas Jefferson UniversityFollow
Pascal Jabbour, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

4-29-2025

Comments

This article is the author's final published version in Journal of Clinical Medicine, Volume 14, Issue 9, May 2025, Article number 3090.

The published version is available at https://doi.org/10.3390/jcm14093090.

Copyright © 2025 by the authors

Abstract

Background/Objectives: Patients with neurovascular conditions often require multidisciplinary management to optimize recovery. Our systematic review identifies literature comparing outcomes among neurovascular patients managed at dedicated neurological intensive care units (ICUs) compared to general ICUs. Methods: PubMed was searched to identify articles that reported outcomes among patients managed at dedicated neurological ICUs versus general ICUs. Articles that reported outcomes among patients with neurovascular conditions were included. Articles that reported outcomes among patients managed at stroke units were excluded. The Newcastle Ottawa Scale (NOS) was used to assess for risk of bias across individual studies. Results: After a title and abstract screen followed by a full-text review, seven studies met criteria for inclusion. These studies reported outcomes among patients managed for intracerebral hemorrhage (ICH), acute ischemic stroke (AIS) and aneurysmal subarachnoid hemorrhage (aSAH). Two studies reported lower mortality, improved functional outcome and reduced costs among patients with ICH who were managed at dedicated neurological ICUs. Among patients with aSAH, only less-severe cases experienced better functional outcome after management at dedicated neurological ICUs. Six out of seven studies were considered high quality. Conclusions: Our review highlights the potential benefits of receiving care at dedicated neurological ICUs, as evidenced by lower mortality, improved functional outcome and reduced costs in patients with ICH and low-grade aSAH. However, future research is necessary to clarify whether dedicated neurological ICU care confers significant advantage over general ICUs among patients with AIS and other neurovascular conditions.

Recommended Citation

Roy, Joanna; Musmar, Basel; Tziviskos, Nassos; Patel, Saarang; DeLeon, Roberto; Thommana, Ashley; Mina, Shady; Tjoumakaris, Stavropoula; Gooch, Michael; Rosenwasswer, Robert; and Jabbour, Pascal, "Comparison of Outcomes Among Neurovascular Patients Managed in Dedicated Neurological Intensive Care Units vs. General Intensive Care Units" (2025). Department of Neurosurgery Faculty Papers. Paper 262.
https://jdc.jefferson.edu/neurosurgeryfp/262

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

40364119

Language

English