P094 Neurovascular patient pathways and outcomes following admission to a tertiary neurosurgical referral centre – A service evaluation of an expanded advanced clinical practice (ACP) team

<h3>Introduction</h3> In 2023 the neurovascular advanced clinical practice (ACP) team expanded to support all patients who had bleed from a neurovascular pathology. To better understand this population and to tailor service development, a service evaluation was completed. <h3>Aim of Study</h3> To describe the population supported by the ACP service, understand patient pathways, and identify common challenges experiences by patients. <h3>Methods</h3> Routinely collected patient data was analysed for patients seen between March 2023 and February 2024, including demographics, admission information, and physical and mental well-being outcome measures at discharge and follow-up. <h3>Results</h3> 229 patients were included. The majority had subarachnoid haemorrhage (76%), with most others having arteriovenous malformations (16%), arteriovenous fistulas (3%) and cavernomas (2%). Mean age was 56 and around half (53%) were female. Half required ICU admission (50%), and 51% had neurological deficits. Median length of stay was 12.5 days (2.1-128 days). Most patients were discharged home (68%), but 24% required inpatient rehabilitation. At discharge 66% rated their physical health as poor or fair and 60% rated their mental health as poor or fair. At a 6-week follow-up, 32% rated their physical health as poor or fair and 42% reported their mental health as poor or fair. Anxiety and/or depression was reported by 76%. Moderate to very severe fatigue was reported by 52% and 63% had ongoing pain. <h3>Conclusion</h3> Neurovascular patients had variable admission and rehabilitation pathways. Physical and mental health concerns were prevalent and persistent at 6-week follow-up. The ACP team supports patients with these challenges along the clinical pathway. <h3>Disclosure of Interest</h3> no.