Morbidity and mortality patterns among neurological patients in the intensive care unit of a tertiary health facility

Abstract

Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin Teaching Hospital (UBTH), a tertiary health institution in Nigeria, was examined over an 18-year period (January 1985 to December 2003. A complete sampling frame was used with all patients' records scrutinized. Results: A total of 187 patients, (16.6% of the total ICU admissions) with neurological morbidity were admitted during the period. We observed that morbidity was high for preventable etiologies -head injury (119 patients constituting 63.7%), tetanus (26 patients constituting 13.9%), hypertensive encephalopathy (12 patients constituting 6.4%) and meningitis (8 patients constituting 4.8%). The case fatality rates for these causes were 50.4%, 61.5%, 66.7% and 62.5% respectively. The case fatality rate for cerebral malaria was 100%. In addition, males (67.9%) were more likely to have trauma-related morbidity (P<.001) than females (32.1%). Overall mortality rate was high (52.4%) and calls for urgent attention. Conclusion:We concluded that preventable morbidities (head injury, tetanus, meningitis and hypertensive encephalopathy) accounted for fatality among neurological patients in the ICU, Benin City, Nigeria. Mortality was higher among those that required significant intensive interventions. Improved public awareness, traffic legislation, prompt emergency medical care and immunization against tetanus and meningitis should reduce morbidity and mortality. Key words: Morbidity, mortality, neurological patients, intensive care unitRésumé Introduction/Objectif: La morbidité et la mortalité des malades neurologiques traités dans le Service de soins intensifs a montré les causes des troubles neurologiques et l'efficacité de la prise en charge. Méthodes: La tendance de la morbidité et de la mortalité des malades neurologiques admis dans le service des soins intensifs du centre hospitalier universitaire du Benin (CHUB), un centre de la sente tertiaire au Nigeria, a été étudié au cours d'une période de 10 ans (janvier 1985 au décembre 2003). Un plan de sondage complet a été utilisé avec tous les dossiers des patients étudiés. Résultats: Un total de 187 patients, (16,6% du total des admissions ICU) atteints de la morbidité neurologique ont été admis au cours de la période. Nous avons noté que le taux de la morbidité est élevé pour les étiologies évitables -blessures de tête (119 patients recensés en 63,7%) ; le tétanos (26 malades recensés en 13,9%) ; hypertension encéphalopathie (12 malades recensés en 6,4%) et la méningite (8 malades recensés en 4,8%) ; Le taux du cas de la fatalité pour ces causes étaient 50,4%, 61,5%, 66,7% et 62,5% respectivement. Le taux du cas de la fatalité pour la fièvre cérébrale était 100%. En outre, sexe masculin (67,9(%) étaient plus susceptibles d'avoir des tra...

Assessment of pattern and treatment outcome of patients admitted to pediatric intensive care unit, Ayder Referral Hospital, Tigray, Ethiopia, 2015

“…This is related to inadequate resources similar to other developing countries [16]. However, this was lower than studies done in other sub-Saharan countries (40–42%) [6, 7, 17, 18]. This may be due to the presence of isolated PICU (others use common ICU for all age) and burn unit of which burns contribute to high case fatality rate for those who have common ICU for all cases [7].…”

“…A similar study of critical care unit of all age patients in Tanzania revealed mortality rate of 41.4% [6]. In a study of severe head injury patients in the ICU of National Hospital Abuja in Nigeria, the mortality rate was 68.4%, [7, 8]. …”

Unknown patients and neurology casualty services in an Indian metropolitan city: A decades experience

“…This shows seizure disorder, stroke is common across the world, and metabolic encephalopathy and head injury were unusually more common at our center compared with the other centers in the world. [234510] It may be due to the following reasons (1) referral bias of general medical causes causing encephalopathy (2) unknown patients subgroup (3) it is tertiary care and referral center for neuropsychiatry care rather than a multispecialty general hospital.…”

“…[2] Cerebro vascular disease (CVD), headache and epilepsy accounted for almost half of all acute admissions related to neurological diseases in western countries. [2345] It is associated with high and increasing public-health costs. [6]…”

Characteristics and Outcomes of Stroke Patients Admitted to the Medical Ward and the Intensive Care Unit of a Tertiary Hospital in Saudi Arabia

“…In contrast to patients admitted to medical ward, patients admitted into the ICU have various critical issues affecting their clinical outcome; ranging from unstable blood pressure that is difficult to control, arrhythmias, myocardial infarction, and impaired level of consciousness or a massive hemispheric or cerebellar infarct. [17] A study had surveyed the outcomes pattern among neurological patients in Saudi Arabia. [18] But to the best of our knowledge no study had reported any case of stroke among the patients studied.…”