Outcome after XXXX improved by an organized secondary insult program and standardized neurointensive care.

@entity1 @entity131 @entity542 @entity772 @entity204
OBJECTIVE: To evaluate today's refined neurosurgical intensive care of @entity1 with @entity131 after implementation of an organized secondary insult program focused on the importance of avoiding secondary brain damage together with a standardized treatment protocol system. DESIGN: Clinical observational @entity1 study. @entity1 : A total of 154 @entity1 16-79 yrs of age with @entity542 and pathologic computed tomographic findings treated between 1996 and 1997. SETTING: Neurointensive care unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Good recovery was obtained in 44% of the @entity1 , moderate disability in 35%, severe disability in 16%, and no @entity1 remained in a vegetative state. Six percent of the @entity1 died, but only two of these @entity1 (1.3%) died as direct result of their @entity542 . When the results for @entity1 with Glasgow @entity772 Scale motor scores of >or=4 were compared with the periods 1980-1981 (preneurosurgical intensive care) and 1987-1988 (basic neurosurgical intensive care), mortality had decreased from 40% in the first period to 27% in the second period and to 2.8% in the present series. Favorable outcome in the same group of @entity1 had increased steadily from 40% in the first period, to 68% in the second period, and finally, to 84% in the present series. CONCLUSIONS: The main observation in this hospital series of @entity131 @entity1 was a low rate of @entity204 directly caused by @entity542 and a high rate of favorable outcome. The comparison of @entity1 with Glasgow @entity772 Scale motor scores of >or=4 with the previously reported results from the same unit indicate that substantial improvement in outcome has been achieved.
