A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries

Jin Heon Jeong, Jae Seung Bang, Won Joo Jeong, Kyu Sun Yum, Jun Young Chang, Jeong Ho Hong, Kiwon Lee, Moon-Ku Han

Research output: Contribution to journalReview articleResearchpeer-review

3 Citations (Scopus)

Abstract

Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients (P =.024, P =.001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3% vs 4.7%, P =.012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9%/26.1%), and 228 (48.1%) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.

Original languageEnglish
Pages (from-to)104-108
Number of pages5
JournalJournal of Intensive Care Medicine
Volume34
Issue number2
DOIs
StatePublished - 1 Feb 2019

Fingerprint

Brain Injuries
Intensive Care Units
Spine
Mortality
Korea
Glasgow Coma Scale
APACHE
Postoperative Care
Medical Records
Ventilation
Demography
Interviews

Keywords

  • mortality
  • neurocritical care team
  • neurointensive care unit
  • neurointensivist
  • outcome

Cite this

Jeong, Jin Heon ; Bang, Jae Seung ; Jeong, Won Joo ; Yum, Kyu Sun ; Chang, Jun Young ; Hong, Jeong Ho ; Lee, Kiwon ; Han, Moon-Ku. / A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries. In: Journal of Intensive Care Medicine. 2019 ; Vol. 34, No. 2. pp. 104-108.
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abstract = "Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients (P =.024, P =.001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3{\%} vs 4.7{\%}, P =.012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9{\%}/26.1{\%}), and 228 (48.1{\%}) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.",
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A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries. / Jeong, Jin Heon; Bang, Jae Seung; Jeong, Won Joo; Yum, Kyu Sun; Chang, Jun Young; Hong, Jeong Ho; Lee, Kiwon; Han, Moon-Ku.

In: Journal of Intensive Care Medicine, Vol. 34, No. 2, 01.02.2019, p. 104-108.

Research output: Contribution to journalReview articleResearchpeer-review

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T1 - A Dedicated Neurological Intensive Care Unit Offers Improved Outcomes for Patients With Brain and Spine Injuries

AU - Jeong, Jin Heon

AU - Bang, Jae Seung

AU - Jeong, Won Joo

AU - Yum, Kyu Sun

AU - Chang, Jun Young

AU - Hong, Jeong Ho

AU - Lee, Kiwon

AU - Han, Moon-Ku

PY - 2019/2/1

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N2 - Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients (P =.024, P =.001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3% vs 4.7%, P =.012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9%/26.1%), and 228 (48.1%) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.

AB - Background: Admission to an intensive care unit (ICU) specialized for brain and spine injury patients is associated with improved outcome. We investigated the effects of the first dedicated, combined neurological and neurosurgical ICU (NeuroICU) in Korea on patient outcomes. Methods: The first dedicated NeuroICU in Korea was established in March 2013. We retrospectively analyzed the clinical data and compared the outcomes between patients admitted to the ICU before and after NeuroICU establishment. The predicted mortality of NeuroICU patients was calculated using their Acute Physiology and Chronic Health Evaluation II scores. Patients’ functional outcomes were evaluated using their modified Rankin scale (mRS) scores at 6 months after ICU admission, which were obtained from medical records or telephone interviews. Results: We included 2487 patients, 1572 and 915 of whom were admitted prior to and after NeuroICU establishment, respectively. The demographic characteristics, Glasgow Coma Scale scores, and disease proportions did not differ significantly between the groups. The length of ICU stay and the number of days on ventilation were significantly lower in NeuroICU patients than they were in general ICU patients (P =.024, P =.001). Intensive care unit mortality was significantly lower in NeuroICU patients (7.3% vs 4.7%, P =.012). The predicted mortality was obtained from 473 NeuroICU patients. The mortality ratio (observed mortality/predicted mortality) was 0.34 (8.9%/26.1%), and 228 (48.1%) patients showed good functional recovery (mRS, 0-2). Conclusion: Our findings suggest that admission to a dedicated NeuroICU significantly improves the neurological outcomes of patients with brain and spine injuries, including their postoperative care, in Korea.

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KW - neurointensivist

KW - outcome

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JF - Journal of Intensive Care Medicine

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