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A review of neurosurgical admissions in a Nigerian Intensive Care Unit

机译:尼日利亚重症监护病房神经外科收治的回顾

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Context: Neurosurgical patients following surgery or trauma are often monitored in an intensive care setting for a period of time. Studies with a comprehensive and predictive model of factors contributing to Intensive Care Unit (ICU) outcome following neurosurgical admissions are few in our environment. Aims: The aim of the study was to document the pattern of neurosurgical ICU admissions and predictors of outcome in our center for improved resource allocation and overall reduction in a poor outcome. Settings and Design: A retrospective study was conducted on adult patients admitted to ICU in 2015 with neurosurgical diagnosis. Subjects and Methods: Patient demographics, admission characteristics, details of neurosurgical diagnosis, ICU interventions, and outcome were obtained from the ICU record. Statistical Analysis Used: Data were analyzed with SPSS version 20. Results: Of 286 patients admitted in the study year, 95 (33.2%) followed neurosurgical indications. Twelve patients below 16 years were excluded leaving 83 adults in the review. Admissions following traumatic brain injury and intracranial tumor surgery each accounted for 35%. Although poorer outcome was observed in the traumatic brain injury, traumatic myelopathy, and clot evacuation groups, the difference was not statistically significant (P 0.34). Forty-two (50.6%) and 28 (34%) patients had ventilatory and vasopressor therapy, respectively. Only Modified Early Warning Score (MEWS) on admission predicted poor outcome (P = 0.04, β =1.63). Conclusions: Traumatic brain injury and intracranial tumor surgery were the main neurosurgical indications for ICU admission. A higher MEWS and lower Glasgow Coma Score on admission were observed among nonsurvivors, but only MEWS on admission predicted poor outcome.
机译:背景:手术或外伤后的神经外科患者通常会在重症监护室中接受一段时间的监控。在我们的环境中,很少有研究针对神经外科手术入院后对重症监护室(ICU)结局做出贡献的因素进行全面而可预测的模型。目的:该研究的目的是在我们中心记录神经外科ICU入院的模式和结果的预测指标,以改善资源分配并总体减少不良结果。设置与设计:回顾性研究针对2015年接受ICU并具有神经外科诊断的成年患者进行。受试者和方法:从ICU记录中获得患者的人口统计学,入院特征,神经外科诊断的详细信息,ICU干预措施和结果。使用的统计分析:使用SPSS 20版对数据进行分析。结果:在本研究年度收治的286例患者中,有95例(33.2%)遵循了神经外科手术指征。该评价排除了12名16岁以下的患者,剩下83名成人。脑外伤和颅内肿瘤手术后的入院率均占35%。尽管在颅脑外伤,脊髓脊髓病和疏散凝块组中观察到较差的结果,但差异无统计学意义(P = 0.34)。分别接受通气和升压治疗的患者有42例(50.6%)和28例(34%)。只有入院时修改后的预警评分(MEWS)预测不良结局(P = 0.04,β= 1.63)。结论:颅脑外伤和颅内肿瘤手术是ICU入院的主要神经外科指征。非幸存者在入院时观察到较高的MEWS和较低的格拉斯哥昏迷评分,但只有入院时MEWS预测结果差。

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