1.Predictors of functional outcome of patients in neurological intensive care unit
Yerim Kim ; Seok-Beom Kwon ; Hyun-Ju Park ; Min-Ji Kim ; SeongSook Hong ; Suk Yun Kang ; San Jung ; Sung-Hee Hwang
Neurology Asia 2012;17(3):219-225
Background: Little is known regarding the functional outcome and quality of life of neuro-ICU
survivors. In Korea, the neuro-ICU concept was introduced relatively late and data about long term
outcome and predictors concerning functional outcome is scarce. The main objective of this study was
to analyze functional outcome and mortality, and to determine prognostic predictors for the outcome
in patients admitted to Korean neuro-ICUs. Methods: Consecutive adult (≥ 15-years-of-age) patients
admitted to a neuro-ICU due to various causes including ischemic or hemorrhagic stroke, and other
neurological or neurosurgical problems such as traumatic brain injury, seizure, or drug intoxication
during an 18-month period from July 2008 through December 2009 were included. Demographic and
clinical variables were compared between groups stratifi ed based on 6-month modifi ed Rankin scale
score. Results: Of 555 patients, there were signifi cant differences in age (P=0.013), sex (P=0.02),
hospital stay (P<0.01), neuro-ICU stay (P<0.01), admission diagnosis (P=0.001), intubation (P<0.01),
mechanical ventilation (P<0.01), tracheostomy (P<0.01), comorbid conditions such as atrial fi brillation
(P<0.01), cardiac complication (P<0.01) and pulmonary complication (P<0.01), a high Therapeutic
Intervention Scoring System (TISS-28) score (P<0.01), and a high Acute Physiology and chronic health
evaluation (APACHE) II score (P<0.01) between favorable and unfavorable outcome groups. The
overall mortality rate was 15.0% (n=83). In multivariable logistic regression analysis, age, sex, high
TISS-28, high APACHE II score, intubation, and cardiac complication were independent predictors
of unfavorable outcome.
Conclusion: The identifi ed predictors for functional outcomes in Korean neuro-ICU patients will be
an important aid in diagnosing and treating neuro-ICU patients.