Epidemiological trends in the neurological intensive care unit from 2000 to 2008.
Intensive care units (ICU) specializing in the treatment of patients with neurological diseases (Neuro-ICU) have become increasingly common. However, there are few data on the longitudinal demographics of this patient population. Identifying admission trends may provide targets for improving resource utilization. We performed a retrospective analysis of admission logs for primary diagnosis, age, sex, and length of stay, for all patients admitted to the Neuro-ICU at Columbia University Medical Center (CUMC) between 2000 and 2008. From 2000 to 2008, inclusive, the total number of Neuro-ICU admissions increased by 49.9%. Overall mean patient age (54.6 ± 17.4 to 56.2 ± 18.0 years, p=0.041) and gender (55.9-50.3% female, p=0.005) changed significantly, while median length of stay (2 days) did not. When comparing the time period prior to construction of a larger Neuro-ICU (2000-2004) to that after completion (2005-2008), patient age (56.0 ± 17.6 compared to 56.9 ± 17.5 years, p=0.012) and median length of stay (1 compared to 2 days, p<0.001) both significantly increased. Construction of a newer, larger Neuro-ICU at CUMC led to a substantial increase in admissions and changes in diagnoses from 2000 to 2008. Advances in neurocritical care, neurosurgical practices, and the local and global expansion and utilization of ICU resources likely led to differences in lengths of stay.
Cerebrovascular Laboratory, Department of Neurological Surgery, Columbia University, College of Physicians and Surgeons, 630 West 168 Street Room 5-454, New York, NY 10032, USA. bez2103@columbia.edu
Brad E
BE
Zacharia
Kerry A
KA
Vaughan
Samuel S
SS
Bruce
Bartosz T
BT
Grobelny
Reshma
R
Narula
Joyce
J
Khandji
Amanda M
AM
Carpenter
Zachary L
ZL
Hickman
Andrew F
AF
Ducruet
E
E
Sander Connolly
D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data / Q000639:trends*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D009462:Neurology / Q000706:statistics & numerical data / Q000639:trends*; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies