International Journal of Neuro & Psychological Disorders

PREVALENCE AND OUTCOME OF NEUROLOGICAL REFERRAL TO THE GENERAL INTENSIVE CARE UNIT

Aysha Al-Shareef* and Reem Alyoubi

mezo106@yahoo.com

Critical care, Hospital mortality, Outcome, Length of stay, Neurological referrals, Intensive care unit, Mortality.

The impact of specialty ICU is not well known which raised question about the real need of a specialized neuro-critical and their impact on patient outcome. To determine the prevalence of neurological referrals to general ICU in comparison to other subspecialties and the mortality rate of neuro-critical patients managed at general ICU. A retrospective study was commenced through reviewing the patients’ records. Data were collected on all patients admitted to ICUs of King Abdul-Aziz University hospital, Jeddah (kAUH) from 1st June 2011- May 31st2012.We include all neurological cases aged over 12 years admitted to the ICU with primary neurologic diagnosis. The following variables were recorded; age , sex , nationality, source of cases, diagnosis on admission, Glasgow comma scale (GCS) on admission to ICU, reason of referral to ICU, ICU length of stay, co-morbidities and need for mechanical ventilation. The outcome was categorized as death and discharged either improved or with ongoing illness). A total 560 patient were referred to general intensive care unit during the period June 1st 2011 to May 31st 2012. Out of them 89 patients were neuro-critical referrals representing 16% of all ICU admissions. Males represent 62.9% of them whereas Saudi patients constitute 22.5% of neurological referred cases. Most of them (74.7%) were referred from emergency department (ER) whereas 14.9% and 9.2% were referred from other hospital wards and operating room (OR), respectively. Length of ICU stay ranged between one and 310 days with a mean of 17.4 days and SD of 37.7 days. Death was reported among 25 cases (28.1%) whereas the remaining 64 (71.9%) patients were discharged. Out of them, 18 patients (28.1%) were improved while the remaining 46 patients (71.9%) expressed ongoing illness. Multivariate logistic regression analysis revealed that Patients aged between 36 and 65 years were at almost six-folded risk for death (Adjusted OR=6.02; 95% CI: 1.61-22.58) and those admitted from other wards were at higher significant risk for death (Adjusted OR=5.50; 95% CI: 1.38-21.86). Neurological patients need a specialized neuro-critical care to improve the patient care, but to reach a better conclusion we should compare the mortality to a neuro-critical care which not available in our medical centre.