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Published on: February 22, 2020
Predictors for good functional outcome after neurocritical care
Ines C Kiphuth1, Peter D Schellinger, Martin Köhrmann
1Department of Neurology, University of Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany. ines-christine.kiphuth@uk-erlangen.de
Critical Care (London, England)
|July 22, 2010
Summary
Long-term outcomes after neurocritical care vary significantly. Age, ventilation duration, and diagnosis predict functional recovery, with hemorrhagic stroke and brain tumors indicating poorer prognoses, while Guillain-Barré syndrome and myasthenia gravis suggest better recovery.
Area of Science:
- Neurology
- Critical Care Medicine
- Neuroscience
Background:
- Limited data exists on long-term outcomes for patients receiving specialized neurocritical care.
- This study aimed to analyze survival, mortality, and functional outcomes post-neurocritical care.
- Key predictors for favorable functional outcomes were identified.
Purpose of the Study:
- To analyze survival and long-term mortality in neurocritical care patients.
- To determine functional outcomes one year after discharge.
- To identify independent predictors of good functional outcome.
Main Methods:
- Retrospective analysis of 796 patients admitted to a non-surgical neurologic intensive care unit.
- Patients grouped by diagnosis: cerebral ischemia, intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH), meningitis/encephalitis, epilepsy, Guillain-Barré syndrome (GBS)/myasthenia gravis (MG), neurodegenerative diseases, cerebral neoplasm, and intoxication.
- Functional outcome assessed using the modified Rankin Scale (mRS) one year post-discharge; logistic regression used to find predictors.
Main Results:
- Overall in-hospital mortality was 22.5%.
- Good long-term functional outcome (mRS ≤ 2) was achieved in 28.4% of patients.
- Independent predictors for good functional outcome included age, length of ventilation (LOV), diagnosis (ICH, GBS/MG, cerebral neoplasm), and TISS-28 score on Day 1.
Conclusions:
- Age, LOV, and TISS-28 on Day 1 are strong predictors of neurocritical care outcomes.
- Hemorrhagic stroke and cerebral neoplasms are associated with poor functional outcomes or death.
- Patients with GBS and MG demonstrate a higher likelihood of recovery following neurocritical care.