Review of Clinico-Demographic Patterns and Profiling of the Determinants of Outcome of Neurological Surgery Admissions in an Intensive Care Unit: Preliminary Study

INTRODUCTION To evaluate the clinico-demographic patterns, and assess the factors determining outcome of neurological surgery admissions to the intensive care unit (ICU) of a tertiary health institution in South -East, Nigeria. METHODS: A retrospective study of all neurological surgery patients admitted into the general ICU of a tertiary health institution over 8 years that ended, March 2016. Relevant data from ICU admission-discharge registersand patients case notes werecollected on proformas. Analysis was done using the Statistical Package for SocialSciences (SPSS Inc. , Chicago, IL, USA) version 20.0. RESULTS: Neurosurgery ICU admissions were 539, males 405 (75.1 %), and 134 (24.9 %) females. Aged 2 months to 80 years (mean 36.65 19.41 years).26.6 % of the admissions in their first 3-decade of life.75.7 % were related to traumatic brain injury (TBI), with most of those injuries resulting from motorcycle and motor vehicular accidents. Other indications were post-operative patient monitoring (10.52 %) and high cervical spinal cord injury (4.78 %) and others.141 patients (26.1 %) had a neurosurgical intervention either prior to or during the ICU admission. Admission into the ICU was delayed in about 20 %. The lengths of admissions ranged from 24 hours to 151 days (median 4 days, mode: 24 hours).56.2 % of admitted patients achieved significant recovery and were discharged. Less than 7 days admission had higher mortality and this was statistically significant. CONCLUSION: Severe TBI was the most common indication for ICU admission. Length of ICU stay influences outcome. More ICU facilities and personnel are needed to further improve outcomes.