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

## TL;DR

Patients with certain neurovascular conditions may have better outcomes when treated in specialized neurological ICUs compared to general ICUs.

## Contribution

This systematic review compares outcomes of neurovascular patients in dedicated versus general ICUs, highlighting benefits for specific conditions.

## Key findings

- Patients with intracerebral hemorrhage had lower mortality and better outcomes in dedicated neurological ICUs.
- Only less-severe aneurysmal subarachnoid hemorrhage cases benefited from dedicated neurological ICU care.
- Six out of seven included studies were of high quality.

## 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.