# Outcome of neurosurgical patients in surgical intensive care unit of a tertiary care center

## TL;DR

This study examines the outcomes of neurosurgical patients in an ICU, highlighting high complication rates and mortality.

## Contribution

The study provides insights into ICU outcomes for neurosurgical patients in a tertiary care setting in Pakistan.

## Key findings

- Neurosurgical ICU patients faced high rates of neurological, metabolic, and respiratory complications.
- ICU mortality was 14.6%, with 50% requiring tracheostomy and 77% transferred to ward care.
- Patients admitted from the ward had longer ICU stays and higher complication rates.

## Abstract

The intensive care unit (ICU) management of neurosurgical patients is critical for early detection of complications, optimizing recovery, and improving outcomes. The study aimed to determine the outcomes of neurosurgical patients admitted to ICU.

After taking exemption from ethical review committee, study was conducted from November 2020 to May 2023 at ICU of a The Aga Khan University Hospital, Pakistan. All adult neurosurgical patients requiring ICU admission were included. Data including demographic variables, comorbid conditions, reasons for ICU referral, complications and expected outcomes were gathered and was analyzed using R. Studio.

Total 93 neurosurgical patients (mean age of 40 years, 69% males) were analyzed. Most of them were admitted to ICU after supratentorial craniotomy (40%). ICU course for them was associated with neurological (78%), metabolic (78%), respiratory (56%), cardiovascular (38%), and infectious (34%) complications. 50% of patients required tracheostomy. The mean length of stay (LOS) in ICU was 6.99 days with ICU mortality of 14.6%. Significant number of these patients (77%) were transferred from the ICU to ward care. The average LOS in ward was 8.43 days, with ward mortality of seven percent. The average LOS in hospital stay was 15.3 days. Comparison of adverse outcomes revealed, patients admitted from ward tend to have the longest ICU stay, higher frequency of having neurological deficit, seizures and sepsis. While higher chances of unsuccessful extubation and need of tracheostomy in patients presented with head injury.

Despite medical advances, morbidity and mortality remain high in neurosurgical patients. The high incidence of neurological, metabolic and respiratory complications and related outcome particularly patients coming from ward and after trauma needs special consideration.