Disease patterns and outcome for medical neurological patients admitted to a multi-disciplinary intensive care unit

Abstract

Aim: To review the disease pattern and outcome for neurological patients admitted to the intensive care unit (1CU) of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria was undertaken. Patients and Methods: The hospital records (case notes ICU records) were reviewed retrospectively for five years and the necessary data were extracted. Neurosurgical patients excluded. Results: There was a total of six hundred and sixty-seven admission to the ICU and twenty-three of these were neurological patients. Cerebrovascular accident (CVA) or stroke was the commonest indication for admission to the IUC at 48% followed by Guillain-Barre syndrome (17%), myasthenia gravis (17%), or neurone disease (13%) and cerebral malaria (4%). Six patients (26%) received mechanical ventilation, while another six (26%) received oxygen via an intranasal catheter or variable performance facemask. Ten patient received pressor agents for organ support. The mortality rate was 43.5% with ten deaths. The deaths were as follows, cerebrovascular accidents (5), Guillain-Barre syndrome (2), myasthenia gravis (2) and motor neurone disease (1). Conclusion: This study showed that while the disease spectrum and pattern of admission was similar to that in the developed nations, the outcome was worse. Provision of modern facilities, including a neuro-intensive care unit may improve outcome in these patients.

Keywords

• medical neurological patients
• intensive care unit
• mortality rate