Hospital-Course Infectious Complications Associated with In-Hospital Mortality in a Neurological Intensive Care...

Area of Science:

• Neurology
• Critical Care Medicine
• Infectious Diseases

Background:

• Infectious complications are common in neurological intensive care units (ICUs).
• These infections can significantly contribute to in-hospital mortality among neurological ICU patients.
• The independent association of these complications with mortality in comprehensive neurological ICU cohorts requires further definition.

Purpose of the Study:

• To evaluate documented hospital-acquired infectious complications as independent factors associated with in-hospital mortality.
• To analyze a six-year cohort of patients admitted to a neurological ICU.
• To assess the impact of specific infections, including pneumonia and sepsis-related coding, on mortality.

Main Methods:

• A retrospective, single-center cohort study was conducted.
• Data from 5509 neurological ICU admission episodes between January 1, 2020, and December 31, 2025, were analyzed.
• Multivariable logistic regression was used to determine independent associations with in-hospital mortality, with sensitivity analyses including Glasgow Coma Scale (GCS).

Main Results:

• The overall in-hospital mortality rate was 18.1% (999 deaths).
• Infectious complications were present in 34.7% of admissions.
• Pneumonia (OR 6.82) and sepsis-related coding (OR 12.40) were independently associated with increased in-hospital mortality, while urinary tract infection and pressure sore-related infection were not after adjustment.

Conclusions:

• Pneumonia and sepsis-related coding are robustly and independently linked to in-hospital mortality in neurological ICUs.
• Infectious complications provide significant prognostic information beyond baseline clinical variables.
• Integrating infection surveillance and risk assessment strategies is recommended for neurological ICUs.