Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia
Background. Dedicated neurocritical care units have dramatically improved the management and outcome following brain injury worldwide. Aim. This is the first study in the Middle East to evaluate the clinical impact of a neurocritical care unit (NCCU) launched within the diverse clinical setting of a...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/2764907 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832554681957613568 |
|---|---|
| author | Ibrahim Soliman Waleed Tharwat Aletreby Fahad Faqihi Nasir Nasim Mahmood Omar E. Ramadan Ahmad Fouad Mady Babar Kahlon Abdulrahman Alharthy Peter Brindley Dimitrios Karakitsos |
| author_facet | Ibrahim Soliman Waleed Tharwat Aletreby Fahad Faqihi Nasir Nasim Mahmood Omar E. Ramadan Ahmad Fouad Mady Babar Kahlon Abdulrahman Alharthy Peter Brindley Dimitrios Karakitsos |
| author_sort | Ibrahim Soliman |
| collection | DOAJ |
| description | Background. Dedicated neurocritical care units have dramatically improved the management and outcome following brain injury worldwide. Aim. This is the first study in the Middle East to evaluate the clinical impact of a neurocritical care unit (NCCU) launched within the diverse clinical setting of a polyvalent intensive care unit (ICU). Design and Methods. A retrospective before and after cohort study comparing the outcomes of neurologically injured patients. Group one met criteria for NCCU admission but were admitted to the general ICU as the NCCU was not yet operational (group 1). Group two were subsequently admitted thereafter to the NCCU once it had opened (group 2). The primary outcome was all-cause ICU and hospital mortality. Secondary outcomes were ICU length of stay (LOS), predictors of ICU and hospital discharge, ICU discharge Glasgow Coma Scale (GCS), frequency of tracheostomies, ICP monitoring, and operative interventions. Results. Admission to NCCU was a significant predictor of increased hospital discharge with an odds ratio of 2.3 (95% CI: 1.3–4.1; p=0.005). Group 2 (n = 208 patients) compared to Group 1 (n = 364 patients) had a significantly lower ICU LOS (15 versus 21.4 days). Group 2 also had lower ICU and hospital mortality rates (5.3% versus 10.2% and 9.1% versus 19.5%, respectively; all p<0.05). Group 2 patients had higher discharge GCS and underwent fewer tracheostomies but more interventional procedures (all p<0.05). Conclusion. Admission to NCCU, within a polyvalent Middle Eastern ICU, was associated with significantly decreased mortality and increased hospital discharge. |
| format | Article |
| id | doaj-art-aebc747e383a42438d8c38dd9f8b9aa8 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-aebc747e383a42438d8c38dd9f8b9aa82025-02-03T05:50:51ZengWileyCritical Care Research and Practice2090-13052090-13132018-01-01201810.1155/2018/27649072764907Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi ArabiaIbrahim Soliman0Waleed Tharwat Aletreby1Fahad Faqihi2Nasir Nasim Mahmood3Omar E. Ramadan4Ahmad Fouad Mady5Babar Kahlon6Abdulrahman Alharthy7Peter Brindley8Dimitrios Karakitsos9Neurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaDepartment of Neurosurgery, King Saud Medical City, Riyadh, Saudi ArabiaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaCritical Care Department, University of Alberta, CanadaNeurocritical Care Unit, Critical Care Department, King Saud Medical City, Riyadh, Saudi ArabiaBackground. Dedicated neurocritical care units have dramatically improved the management and outcome following brain injury worldwide. Aim. This is the first study in the Middle East to evaluate the clinical impact of a neurocritical care unit (NCCU) launched within the diverse clinical setting of a polyvalent intensive care unit (ICU). Design and Methods. A retrospective before and after cohort study comparing the outcomes of neurologically injured patients. Group one met criteria for NCCU admission but were admitted to the general ICU as the NCCU was not yet operational (group 1). Group two were subsequently admitted thereafter to the NCCU once it had opened (group 2). The primary outcome was all-cause ICU and hospital mortality. Secondary outcomes were ICU length of stay (LOS), predictors of ICU and hospital discharge, ICU discharge Glasgow Coma Scale (GCS), frequency of tracheostomies, ICP monitoring, and operative interventions. Results. Admission to NCCU was a significant predictor of increased hospital discharge with an odds ratio of 2.3 (95% CI: 1.3–4.1; p=0.005). Group 2 (n = 208 patients) compared to Group 1 (n = 364 patients) had a significantly lower ICU LOS (15 versus 21.4 days). Group 2 also had lower ICU and hospital mortality rates (5.3% versus 10.2% and 9.1% versus 19.5%, respectively; all p<0.05). Group 2 patients had higher discharge GCS and underwent fewer tracheostomies but more interventional procedures (all p<0.05). Conclusion. Admission to NCCU, within a polyvalent Middle Eastern ICU, was associated with significantly decreased mortality and increased hospital discharge.http://dx.doi.org/10.1155/2018/2764907 |
| spellingShingle | Ibrahim Soliman Waleed Tharwat Aletreby Fahad Faqihi Nasir Nasim Mahmood Omar E. Ramadan Ahmad Fouad Mady Babar Kahlon Abdulrahman Alharthy Peter Brindley Dimitrios Karakitsos Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia Critical Care Research and Practice |
| title | Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia |
| title_full | Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia |
| title_fullStr | Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia |
| title_full_unstemmed | Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia |
| title_short | Improved Outcomes following the Establishment of a Neurocritical Care Unit in Saudi Arabia |
| title_sort | improved outcomes following the establishment of a neurocritical care unit in saudi arabia |
| url | http://dx.doi.org/10.1155/2018/2764907 |
| work_keys_str_mv | AT ibrahimsoliman improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT waleedtharwataletreby improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT fahadfaqihi improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT nasirnasimmahmood improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT omareramadan improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT ahmadfouadmady improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT babarkahlon improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT abdulrahmanalharthy improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT peterbrindley improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia AT dimitrioskarakitsos improvedoutcomesfollowingtheestablishmentofaneurocriticalcareunitinsaudiarabia |