Rashid S, Joubert I, Semple P
Division of Neurosurgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, South Africa.
Division of Critical Care, Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
South Afr J Crit Care. 2023 Dec 13;39(3):e1217. doi: 10.7196/SAJCC.2023.v39i3.1217. eCollection 2023.
At Groote Schuur Hospital (GSH), the neurosurgical intensive care unit (NsICU) is a 6-bed unit headed by a specialist neurosurgeon with extensive experience in neurocritical care, working in close collaboration with intensivists from the Division of Critical Care. There is currently no detailed analysis of the demographics, diagnosis and management of patients admitted to the NsICU at GSH.
To provide a detailed descriptive analysis of the demographics, diagnosis and management of patients admitted to the NsICU at GSH from 1 January 2020 to 31 December 2021.
A retrospective descriptive analysis was done of patients who received treatment in the NsICU from 1 January 2020 to 31 December 2021.
A total of 685 patients were admitted to the unit over a 2-year period, with a male preponderance (68.2%). The average age was 42.5 (standard deviation (SD) 17.2) years. The most common neurosurgical diagnoses were traumatic brain injuries (39.6%), brain tumours (22.6%) and aneurysmal subarachnoid haemorrhages (9.9%). Emergency admissions comprised 76.6% of the total and 86.7% of patients were admitted postoperatively. Three hundred and seventy-two patients (54.3%) required mechanical ventilation, 132 (19.3%) required both an intracranial pressure (ICP) monitor and brain tissue oxygenation monitor, 86 (12.5%) needed placement of an external ventricular drain, 50 (7.3%) needed placement of a tracheostomy tube and 16 (2.3%) needed placement of an ICP monitor only. The average duration of stay was 5.5 (1.3) days and NsICU mortality over 2 years was 11.1%.
The NsICU at GSH manages predominantly male trauma patients and a significant number of admitted patients require specialised invasive intracranial monitoring.
This is the first in-depth analysis of patients managed in a dedicated neurosurgical intensive care unit in South Africa. The work defines the patient population, neurosurgical pathologies and service level requirements that would likely be encountered by teams building a similar service.
在格罗特舒尔医院（GSH），神经外科重症监护病房（NsICU）是一个拥有6张床位的科室，由一位在神经重症监护方面经验丰富的神经外科专家领导，与重症监护科的重症医学专家密切合作。目前尚无对GSH医院NsICU收治患者的人口统计学、诊断和管理情况的详细分析。
对2020年1月1日至2021年12月31日期间入住GSH医院NsICU的患者的人口统计学、诊断和管理情况进行详细的描述性分析。
对2020年1月1日至2021年12月31日期间在NsICU接受治疗的患者进行回顾性描述性分析。
在两年期间，该科室共收治685例患者，男性居多（占68.2%）。平均年龄为42.5岁（标准差（SD）17.2）。最常见的神经外科诊断为创伤性脑损伤（39.6%）、脑肿瘤（22.6%）和动脉瘤性蛛网膜下腔出血（9.9%）。急诊入院患者占总数的76.6%，86.7%的患者术后入院。372例患者（54.3%）需要机械通气，132例（19.3%）需要同时使用颅内压（ICP）监测仪和脑组织氧合监测仪，86例（12.5%）需要放置外置脑室引流管，50例（7.3%）需要放置气管切开套管，16例（2.3%）仅需要放置ICP监测仪。平均住院时间为5.5（1.3）天，两年间NsICU的死亡率为11.1%。
GSH医院的NsICU主要收治男性创伤患者，且大量入院患者需要进行专门的有创颅内监测。
这是对南非一家专门的神经外科重症监护病房收治患者的首次深入分析。该研究明确了建立类似服务的团队可能会遇到的患者群体、神经外科病理情况和服务水平要求。
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