Health & Medical intensive care

Predictors for Good Functional Outcome After Neurocritical Care

Predictors for Good Functional Outcome After Neurocritical Care

Abstract and Introduction


Introduction: There are only limited data on the long-term outcome of patients receiving specialized neurocritical care. In this study we analyzed survival, long-term mortality and functional outcome after neurocritical care and determined predictors for good functional outcome.
Methods: We retrospectively investigated 796 consecutive patients admitted to a non-surgical neurologic intensive care unit over a period of two years (2006 and 2007). Demographic and clinical parameters were analyzed. Depending on the diagnosis, we grouped patients according to their diseases (cerebral ischemia, intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH), meningitis/encephalitis, epilepsy, Guillain-Barré syndrome (GBS) and myasthenia gravis (MG), neurodegenerative diseases and encephalopathy, cerebral neoplasm and intoxication). Clinical parameters, mortality and functional outcome of all treated patients were analyzed. Functional outcome (using the modified Rankin Scale, mRS) one year after discharge was assessed by a mailed questionnaire or telephone interview. Outcome was dichotomized into good (mRS ≤ 2) and poor (mRS ≥ 3). Logistic regression analyses were calculated to determine independent predictors for good functional outcome.
Results: Overall in-hospital mortality amounted to 22.5% of all patients, and a good long-term functional outcome was achieved in 28.4%. The parameters age, length of ventilation (LOV), admission diagnosis of ICH, GBS/MG, and inoperable cerebral neoplasm as well as Therapeutic Intervention Scoring System (TISS)-28 on Day 1 were independently associated with functional outcome after one year.
Conclusions: This investigation revealed that age, LOV and TISS-28 on Day 1 were strongly predictive for the outcome. The diagnoses of hemorrhagic stroke and cerebral neoplasm leading to neurocritical care predispose for functional dependence or death, whereas patients with GBS and MG are more likely to recover after neurocritical care.


Within the last decades, specialized neurocritical intensive care units (NICU) have evolved from bigger, multi-disciplinary ICUs. This specialization has led to a decrease in both in-hospital mortality and length of hospital stay without associated effects on readmission rates and long-term mortality. Nevertheless, case fatality of patients admitted to NICUs is still high and the outcome often poor. Yet, there are still little data on clinical parameters associated with long-term outcome after neurocritical care; aside from age, the major determinant for outcome, hospital length of stay and the diagnosis of stroke have been shown to negatively influence outcome.

In order to provide data that facilitate the assessment of long-term prognosis after neurocritical care we aimed to identify predisposing factors for a good functional recovery one year after treatment on a specialized neurocritical care unit.

You might also like on "Health & Medical"

Leave a reply