SAN DIEGO, CA -- Patients with serious neurological conditions may have a better chance of survival in a Neurological/Neurosurgical Intensive Care Unit (Neuro-ICU) rather than a general Intensive Care Unit (ICU), according to research presented during the American Academy of Neurology's 52nd Annual Meeting in San Diego, CA, April 29 -- May 6, 2000.
"A Neurological/Neurosurgical Intensive Care Unit is geared toward treating patients with injuries or illnesses affecting the nervous system, including the brain," said Michael Diringer, MD, study author and neurologist at Washington University School of Medicine in St. Louis, Missouri. "Neuro-ICU's have specialized teams of doctors, nurses and therapists that focus on care of these types of patients."
The value of specialty care ICU's is often debated. From a management or cost perspective, having fewer and larger ICU's is usually preferred. However, the impact of specialty ICU care in improving patient outcome has not been previously examined.
The researchers studied admissions information on 1,038 patients with intracerebral hemorrhage -- bleeding in the brain -- who were admitted to either a Neuro-ICU or another type of ICU. They found a 3.3-fold increase in hospital mortality among patients not in a Neuro-ICU. Actual mortality rates were 40 percent for those admitted to general medical ICU's compared to 35 percent in Neuro-ICU's.
Adjustments were made for patient demographics, such as age and gender, and the severity of hemorrhage. Other factors associated with higher mortality were age, the level of the patient's alertness at time of admission, and the total number of intracerbral hemorrage patients admitted to a particular ICU (reflecting the ICU's familiarity with the condition and appropriate treatment).
Diringer cautions that the study findings are preliminary and include information from only two Neuro-ICU's. "This is not by any means the final word; it is the first look at this question," says Diringer.
The American Academy of Neurology, an association of more than 16,500 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. For more information about the American Academy of Neurology, visit its Web site at www.aan.com. For online neurological health and wellness information, visit NeuroVista at www.aan.com/neurovista.
EDITOR'S NOTE: Dr. Diringer will present the study at the American Academy of Neurology's 52nd Annual Meeting in San Diego, CA, during a platform presentation on Wednesday, May 3, 2000, at 9:00 am in Room 7AB of the San Diego Convention Center.