Case management in cerebral revascularization

Robert M. Hoyle, Judith M. Jenkins, William Edwards, William H. Edwards, Raymond S. Martin, Joseph L. Mulherin

    Research output: Contribution to journalArticle

    29 Citations (Scopus)

    Abstract

    Purpose: We examined the clinical and financial outcomes of case management coupled with the initiation of selective use of the intensive care unit (ICU) in all cerebral revascularization procedures. Methods: Three hundred eighty-four procedures in 331 patients were retrospectively reviewed. Morbidity and mortality rates, hospital length of stay, cost, and ICU or hospital readmissions were examined. Hypertension was examined as an independent variable for its effect on patient outcome. Results: Cerebral revascularization, including carotid endarterectomy, vertebral-carotid artery transposition, and subclavian-carotid artery transposition, yielded a 0.78% stroke rate and 0.26% perioperative death rate in this series. ICU admission was necessary in nine patients (2.3%) for cardiac or respiratory instability. Three patients (0.78%) required transfer to the ICU for management of hypertension or hypotension. The mean hospital length of stay after institution of case management was reduced by 2.1 days, and the mean cost was decreased by $1987, a savings of 28.9% of total hospital cost. Conclusion: The dual approach of case management and selective use of the ICU promotes quality patient care, conserves financial resources without adversely affecting morbidity or mortality rates, enhances physician/nurse collaboration, and improves patient satisfaction.

    Original languageEnglish (US)
    Pages (from-to)396-402
    Number of pages7
    JournalJournal of Vascular Surgery
    Volume20
    Issue number3
    DOIs
    StatePublished - Jan 1 1994

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    Cerebral Revascularization
    Case Management
    Intensive Care Units
    Length of Stay
    Carotid Arteries
    Mortality
    Hypertension
    Morbidity
    Costs and Cost Analysis
    Patient Readmission
    Subclavian Artery
    Vertebral Artery
    Carotid Endarterectomy
    Hospital Costs
    Quality of Health Care
    Patient Satisfaction
    Hypotension
    Patient Care
    Stroke
    Nurses

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Cardiology and Cardiovascular Medicine

    Cite this

    Hoyle, R. M., Jenkins, J. M., Edwards, W., Edwards, W. H., Martin, R. S., & Mulherin, J. L. (1994). Case management in cerebral revascularization. Journal of Vascular Surgery, 20(3), 396-402. https://doi.org/10.1016/0741-5214(94)90138-4

    Case management in cerebral revascularization. / Hoyle, Robert M.; Jenkins, Judith M.; Edwards, William; Edwards, William H.; Martin, Raymond S.; Mulherin, Joseph L.

    In: Journal of Vascular Surgery, Vol. 20, No. 3, 01.01.1994, p. 396-402.

    Research output: Contribution to journalArticle

    Hoyle, RM, Jenkins, JM, Edwards, W, Edwards, WH, Martin, RS & Mulherin, JL 1994, 'Case management in cerebral revascularization', Journal of Vascular Surgery, vol. 20, no. 3, pp. 396-402. https://doi.org/10.1016/0741-5214(94)90138-4
    Hoyle RM, Jenkins JM, Edwards W, Edwards WH, Martin RS, Mulherin JL. Case management in cerebral revascularization. Journal of Vascular Surgery. 1994 Jan 1;20(3):396-402. https://doi.org/10.1016/0741-5214(94)90138-4
    Hoyle, Robert M. ; Jenkins, Judith M. ; Edwards, William ; Edwards, William H. ; Martin, Raymond S. ; Mulherin, Joseph L. / Case management in cerebral revascularization. In: Journal of Vascular Surgery. 1994 ; Vol. 20, No. 3. pp. 396-402.
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