Dados do Trabalho

Título

Clinical profiles and hospital outcomes of neurocritical care patients admitted to a dedicated neurosurgical center: 10 years of the Brain Institute

Objetivo

The Instituto Estadual do Cérebro Paulo Niemeyer (IECPN) is a public dedicated neurosurgical center with 44 adult Neuro ICU beds . The objetive of this study was to investigate the clinical profiles, organ support, complications, and hospital outcomes of patients admitted in the Neuro ICU.

Métodos

We included all consecutive patients admitted to the ICU from 2013 to 2024. Clinical characteristics and 30-day hospital mortality data were retrieved from an electronic ICU quality registry. Descriptive statistics with N(%) and median (interquartile range) were used.

Resultados

Overall, 11,389 adult patients were admitted to the Neuro ICU. Age was 55 (43-65) years, 59% were female, 1% were considered previously frail, and 55% were functionally independent. Hypertension was present in 49% and diabetes in 15%. Elective neurosugeries were responsible for 67% of ICU admissions, while 25% had initial clinical diagnoses and 8% underwent urgent neurosurgery. Median SAPS 3 was 30 (24-37) and overall 30-day hospital mortality was 6%. Amongst those admitted for brain tumor ressections (N=6,190), 24% had acute altered mental status, 3.4% were mechanically ventilated, length of hospital stay was 6 (4-10) days, and 30-day mortality was 5%. The most common tumors were gliomas, hypophyseal, and meningiomas (Figure 1). Amongst those with nontraumatic SAH (N=819), SAPS 3 was 36 (31-44), SOFA score was 2 (0-4), vasopressors were required in 15% and mechanical ventilation in 19%. LOS was 12 (7-22) days and mortality was 15%.

Conclusão

Our study showed profiles and outcomes of the first 10 years of a public dedicated neurosurgical institution in Brazil.