News - Hypertension Week of November 9, 2003/ Vol. 2 No. 45

Study: Brain Hemorrhage Patients Fare Better at High-Volume Hospitals

Patients suffering subarachnoid hemorrhages who are treated at hospitals that handle a high volume of such cases have a greater chance of survival than patients treated at less-experienced hospitals, according to a study reported in the November issue of Neurosurgery.

Subarachnoid hemorrhages involve bleeding around the brain and are usually caused by a ruptured brain aneurysm. High blood pressure can also play a role.

Nearly 30,000 Americans suffer these hemorrhages each year and more than half of them die within 30 days of the attack.

However, researchers found that patients treated at high volume centers have a 40 percent better chance of leaving the hospital alive than patients treated at low volume centers, according to the study.

High volume hospitals tend to have more specialists on staff, rely on more sophisticated and less invasive imaging equipment and use a team approach to treatment, the researchers said. High-volume centers also benefit from experienced neurological intensive care units and offer both surgical and endovascular treatment.

Study author Dr. DeWitte Cross, of Washington University's Barnes-Jewish Hospital, said centralizing treatment of this disease in high volume centers would lead to significantly more subarachnoid hemorrhage patients surviving than is currently the case.

Dr. Daniel Barrow, chairman of neurosurgery at Emory University in Atlanta, emphasized that the study does not suggest that some physicians and hospitals are delivering low quality care.

"Rather, the data demonstrates that on average, high volume centers generate better medical outcomes due to a multiplicity of factors related to specialized stroke care," said Barrow. "Volume brings experience and most high volume centers are specialized but there are also some smaller centers that specialize and offer excellent care."

Unfortunately, Barrow added that a significant number of patients are not taken to specialized centers when they suffer a subarachnoid hemorrhage. He emphasized the need for medical personnel who first care for these patients to recognize the potential benefits of getting these patients to high volume multi-disciplinary centers whenever possible.

Other sources: Neurology