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Severe head injury patients in a multidisciplinary ICU: are they a burden?
S Kannan1, K S Marudachalam, G D Puri
1Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India. achalu@aol.com
Insights
Patients with severe head injury (HI) do not significantly increase the burden on intensive care units (ICUs). This study found similar outcomes and complications compared to other ICU patients, challenging the perception of HI patients as an extra load.
Area of Science:
- Intensive Care Medicine
- Trauma Surgery
- Neurology
Background:
- Severe head injury (HI) patients are often perceived as a significant burden in multidisciplinary intensive care units (ICUs).
- Understanding the resource utilization and outcomes of these patients is crucial for effective ICU management.
Purpose of the Study:
- To compare severe closed head injury (HI) patients with other ICU patients regarding demographics, length of stay, complications, and outcomes.
- To evaluate whether severe HI patients represent an additional burden in a multidisciplinary ICU setting.
Main Methods:
- Retrospective analysis of patients admitted to a multidisciplinary ICU in Northern India between January 1995 and December 1997.
- Patients were divided into two groups: Group A (severe closed HI) and Group B (all other patients).
- Comparison focused on age, ICU stay duration, ventilator use, complications, and mortality rates.
Main Results:
- The mean age was similar in both groups (around 30 years).
- Group A patients had a statistically longer ICU stay (12.71 days) compared to Group B (9.9 days).
- Mortality rates were comparable (46.8% in Group A vs. 38.5% in Group B), with no significant difference in common complications like hypotension, renal failure, or septicaemia.
Conclusions:
- Severe head injury patients do not impose an extra burden on multidisciplinary ICUs.
- Resource utilization and outcomes for severe HI patients are comparable to the general ICU population, challenging previous assumptions.
Objective:
Patients with severe head injury (HI) are often considered to be a burden in a multidisciplinary intensive care unit (ICU). This study was undertaken to compare the severe closed HI patients with all other patients in the ICU in terms of age group involved, stay in the unit, complications and outcome.
Design:
Retrospective analysis.
Setting:
Multidisciplinary ICU of a tertiary care hospital in Northern India.
Patients And Participants:
All the patients admitted to the ICU between January 1995 and December 1997. The patients were classified into two groups: group A comprising patients with severe closed HI and group B consisting of all other patients.
Results:
The mean age of the patients was around 30 years in both the groups. The average stay of the patients in the unit was 12.71 +/- 11.9 days in group A, compared to 9.9 +/- 14.4 days for group B (p < 0.05). The duration on the ventilator or on an endotracheal airway was not different between the groups (p > 0.05). The mortality in group A was 46.8 % and that in group B was 38.5 % (p > 0.05). The mortality was directly proportional to the age in group A. Hypotension, renal failure and septicaemia were the commonest complications in both the groups but the difference was not statistically significant.
Conclusions:
This study demonstrates that patients with severe HI do not pose an extra burden in a multidisciplinary ICU.