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Behrouz R.,University of Texas Health Science Center at San Antonio | Godoy D.A.,The Neurointensive Care Unit | Azarpazhooh M.R.,University of Western Ontario | Di Napoli M.,Neurological Service | Di Napoli M.,Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention
Journal of Critical Care | Year: 2015

Altered mental status is a common pathological entity in critically ill patients and particularly in those with preexisting cerebral injury. In the neurological critical care unit, the prevalence of altered mental status is especially high because of the inherent nervous system disease of these patients. Altered mental status can be crudely divided into encephalopathy and delirium. Although often used interchangeably, the 2 pathological entities have subtle differences in etiology and presentation. This is a review of delirium and encephalopathy in the neurological critical care unit. © 2015 Elsevier Inc. Source


Behrouz R.,University of Texas Health Science Center at San Antonio | Godoy D.A.,The Neurointensive Care Unit | Topel C.H.,University of Texas Health Science Center at San Antonio | Birnbaum L.A.,University of Texas Health Science Center at San Antonio | And 8 more authors.
Neurocritical Care | Year: 2016

Background: Hypoalbuminemia has been identified as a predictor of morbidity and mortality in critically ill patients. There is very little data on the significance and the prognostic value of hypoalbuminemia in patients with aneurysmal subarachnoid hemorrhage (aSAH). This study analyzed the impact of hypoalbuminemia on patient presentation, complications, and outcomes. Methods: Records of patients admitted with aSAH were examined. Data on baseline characteristics, prevalence of delayed cerebral ischemia, and discharge outcomes were collected. Multivariable logistic regression analysis was performed to assess for associations. Results: One-hundred and forty-two patients comprised the study cohort (mean age 54.6 ± 13.4), among which 45 (31.5 %) presented with hypoalbuminemia. No difference in baseline characteristics was noted between patients with hypoalbuminemia and those with normal serum albumin. The overall hospital mortality rate was significantly higher in patients with hypoalbuminemia, compared to those with normal albumin (28.9 % vs. 11.3 %; p = 0.04). Hypoalbuminemia was neither associated with delayed cerebral ischemia nor disability at discharge, but independently associated with in-hospital death (odds ratio: 4.26, 95 % confidence interval: 1.09–16.68; p = 0.04). Conclusion: In patients with aSAH, early hypoalbuminemia is an independent predictor of hospital mortality but not disability at discharge. © 2016 Springer Science+Business Media New York Source

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