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INTRODUCTION

DRG Category: 70

Mean LOS: 7.4 days

Description MEDICAL: Nonspecific Cerebrovascular Disorders with Major CC

DRG Category: 84

Mean LOS: 3.9 days

Description MEDICAL: Traumatic Stupor and Coma, Coma > 1 hour without CC or Major CC

DRG Category: 955

Mean LOS: 12.8 days

Description SURGICAL: Craniotomy for Multiple Significant Trauma

classification section:

Stroke, formerly known as cerebrovascular accident (CVA), is the interruption of normal blood flow in one or more of the blood vessels that supply the brain. The tissues become ischemic, leading to hypoxia or anoxia with destruction or necrosis of the neurons, glia, and vasculature. Stroke is the third leading cause of death in the United States and affects more than 600,000 Americans annually with 160,000 deaths per year. The incidence of first-time strokes is approximately 400,000 per year, but as the population ages, the incidence will increase to 1 million per year by 2050.

Stroke is an acute neurological injury that occurs because of changes in the blood vessels of the brain. The changes can be intrinsic to the vessel (atherosclerosis, inflammation, arterial dissection, dilation of the vessel, weakening of the vessel, obstruction of the vessel) or extrinsic, such as when an embolism travels from the heart. Although reduced blood flow interferes with brain function, the brain can remain viable with decreased blood flow for long periods of time. However, total cessation of blood flow produces irreversible brain infarction within 3 minutes. Once the blood flow stops, toxins released by damaged neurons, cerebral edema, and alterations in local blood flow contribute to neuron dysfunction and death. Complications of stroke include unstable blood pressure, sensory and motor impairment, infection (encephalitis), pneumonia, contractures, and pulmonary emboli.

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