PATTERN OF CLINICAL PRESENTATION AND OUTCOME OF NEUROLOGICAL DISORDERS IN CRITICAL CARE

Abstract

Objective: Patients with neurological disorders are commonly seen in the intensive care units. There is a need to constantly monitor the pattern of their data in order to optimize their management and improve outcome. The present study targeted to appraise the pattern of neurological disorders and their outcomes in an intensive care unit.

Study Design: Retrospective Cross-sectional study. Place and Duration of Study: Department of Critical Care Medicine (CCM), Pakistan Institute of Medical Sciences (PIMS), Islamabad. 09 years (2014-2022).

Patients and Methods: A retrospective study was carried out in the Medical Intensive Care Unit(MICU) of PIMS, a tertiary care facility in the federal capital, Islamabad. Data registers were reviewed for retrieving information regarding demographics, clinical presentation and final outcome of patients. Ethical clearance of the study was taken and administrative permission for data usage was granted by departmental head. The categorical variables were measured as frequency & percentage while the continuous numerical data as mean & standard deviation.

Results: The mean age of the patients was 33.0 ± 15.3 years, with male gender in slight majority 178 (53.9%). Guillain-Barre syndrome (GBS) in 66 (20.0%) cases, status epilepticus 57 (17.2%), encephalitis 44 (13.3%), Cerebral venous thrombosis (CVT) 41 (12.4%), tuberculous meningitis 35 (10.6%), and bacterial meningitis 18 (5.4%) were the main diagnoses. There were 92 (27.8%) deaths and 234 (70.9%) recoveries in patients with neurological disorders. Mortality was found on the rise with 34.4% deaths of neurological patients in the Intensive Care Unit (ICU) in 2022, compared with 20.8% in 2014.

Conclusion: GBS, status epilepticus, encephalitis, CVT, tuberculous meningitis and bacterial meningitis were the main neurological conditions. More than one-fourth patients died, most of them were between 20 and 40 years who had comorbid conditions like diabetes and hypertension