Should neurology patients be treated in the general intensive care unit or not?
Ilhan Cag1, Ali Zeynal Abidin Tak1, Yasar Altun1, Oznur Uludag2, Fatih Uckardes3, Emre Gedik1
1Adiyaman University Faculty of Medicine, Department of Neurology, Adiyaman, Turkey
2Adiyaman University Faculty of Medicine, Department of Anesthesiology and Reanimation, Adiyaman, Turkey
3Adiyaman University Faculty of Medicine, Department of Medical Informatics and Biostatistics, Adiyaman, Turkey
Aim: To examine neurology patients treated in a general intensive care unit for more efficient use of intensive care beds as well as for underscoring the need for neurological intensive care units.
Material and Methods: Demographic characteristics, concomitant conditions, duration of intensive care unit stay, prognosis, and the need and reasons for mechanical ventilation were examined and recorded in a cohort of patients admitted to the tertiary intensive care unit of the Research and Training Hospital, Adiyaman University between January 2014 and December 2015.
Results: A total of 164 patients, (82 male and 82 female) with a mean age of 74.18 ± 12.72 years (range: 28-99) admitted and followed up in a tertiary intensive care unit were assessed. The most common indication for admission was ischemic cerebrovascular disease (n=124, 75.6%). The mean duration of intensive care unit stay was 10.76 ± 12 days. Pneumonia, multi-organ failure syndrome, acute respiratory distress syndrome, menengitis, and respiratory arrest were found in 21.3%, 14.0%, 1.8%, 0.6%, and 28.7% of the patients, respectively. Invasive mechanical ventilatory support was given to 48.2% of the cases, with a mean duration of 3.84 ± 7.57 days. In all, 17.7% of the patients survived.
Conclusion: Prolonged duration of intensive care unit stay in critically ill patients as well as the occurrence of concomitant conditions lead to an increased need for invasive mechanical ventilation with an associated increase in mortality. We believe that admission of critically ill patients to specialized intensive care units or closed-system intensive care units with multi-disciplinary care may help improve the prognosis and the quality of care.
Keywords: Intensive Care Unit; Cerebrovascular Disease; Invasive Mechanical Ventilation.