ArticleMayo Clinic proceedings. Innovations, quality & outcomes2020
Subarachnoid Hemorrhage "Fast Track": A Health Economics and Health Care Redesign Approach for Early Selected Hospital Discharge.
Article in Mayo Clinic proceedings. Innovations, quality & outcomes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review of Direct Hospital Costs Associated with Aneurysmal Subarachnoid Hemorrhage Management.Neurocritical care · 2026Pooled it
- Time-Driven Activity-Based Costing Methodology for Cost Savings in the EMOTE-TNK Study.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Aneurysmal Subarachnoid Hemorrhage Risk Assessment Model Identifies Patients for Safe Early Discharge at Day 15-The SAFE-SaH Score.Neurocritical care · 2025Article
- Evaluation of reporting in time-driven activity-based costing studies on cardiovascular diseases: a scoping review.Journal of comparative effectiveness research · 2025Article
- Stroke Unit as an alternative to Intensive Care Unit for initial hospital admission of low-grade non-aneurysmal subarachnoid haemorrhage: A safety and cost-minimisation analysis.European stroke journal · 2024Article
- Safety and Feasibility of a Fast-Track Pathway for Neurosurgical Craniotomy Patients: Bypassing the Intensive Care Unit.Mayo Clinic proceedings. Innovations, quality & outcomes · 2023Article
- Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage.BMC neurology · 2023Article
- Quality Improvement in the Management of Subarachnoid Hemorrhage: Current State and Future Directions.Current pain and headache reports · 2023Review
- The Role of Nursing Care in the Management of Patients with Traumatic Subarachnoid Hemorrhage.Galen medical journal · 2023Article
- Conditional Vasospasm-Free Survival Following Aneurysmal Subarachnoid Hemorrhage.Neurocritical care · 2022Article
- Pragmatic considerations and approaches for measuring staff time as an implementation cost in health systems and clinics: key issues and applied examples.Implementation science communications · 2022Article
- Developing a "Fast-Track" Strategy for Interventional Management of Patients With Idiopathic Intracranial Hypertension.Frontiers in ophthalmology · 2022Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether earlier hospital discharge is feasible and safe in selected patients with subarachnoid hemorrhage (SAH) using an outpatient "fast-track" protocol. PATIENTS AND
methodsWe conducted a prospective quality improvement cohort study with the primary feasibility end point of patients with SAH deemed safe for discharge by treating team consensus. All patients received detailed education and outpatient transcranial Doppler monitoring; caregivers could contact the on-call team 24-7. Primary safety end points were adverse events after discharge and hospital readmission.
resultsFrom January 1, 2010, to January 1, 2015, our center had 377 SAH diagnoses, of which 200 were included in the final cohort, 36 qualifying for fast-track early discharge. The 30-day readmission rate for fast-track patients was 11.0% (4 of 36) compared with 11.4% (18 of 164) for non-fast-track patients. The rate of delayed cerebral ischemia and stroke was 3% (1 of 36) in the fast-track group vs 25.0% (41 of 164) for the non-fast-track group. Adverse events occurred in 11.0% (4 of 36) of the fast-track group compared with 26.0% (43 of 164) in the non-fast-track group. The mean length of stay was reduced 60% from 15 days to 6.6 days in the fast-track group.
conclusionAlthough our fast-track group was relatively small, data suggested early feasibility and safety in a carefully selected group of patients with SAH. Direct and indirect financial benefits of early discharge over a 5-year period were an estimated savings at least $864,000 in overall costs. A comparative effectiveness study is planned to replicate and validate these results using a larger multicenter design.
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