Neurocritical Care Audit in A Tertiary Institution

Abstract

Background: The ‘open’ intensive care unit (ICU) predominates in most low and middle economy societies. This is associated with paucity of personnel and cost challenges involved for its maintenance and smooth running despite the great public demand for this service. Data on neurocritical care in scare in Nigeria and the subregion as a whole. Our objective is to audit our neurocritical care facility, human resources, patient admission and outcome.

Patients and Method: We conducted a retrospective audit of all patients admitted to our ‘open’ ICU following a neurological indication. This study was carried out over a one year period (January 2008-December 2008). In addition to patients’ boidata, we recorded date of admission, indication for admission, treatment (operative/non operative), ventilatory support if any, and outcome (Alive or dead).

Results: One hundred and twenty-nine patients were admitted during the study period, 85 (65.9%) of which was due primarily to a Neurosurgical indication. The overall mortality was 25.9% while mortality of ventilated patients was 64.5%. Mortality rate was significantly by ventilation.

Conclusion: Neurological patients account for most of our ICU admission. Hospitals with ICUs should ensure that they have a proper high dependency unit. We also recommend that appropriate equipments and staff training in the area of neurocritical care be incorporated into existing ‘open’ ICUs in our environment. The use of protocol for ventilated patients and managing common ICU cases and common procedures should enhance treatment outcomes.