Abstract TP437: Clinical Outcomes of the First Neurocritical Care Unit in Korea

Abstract

Introduction: In neurocritically ill patients, admission to a specialized neurocritical care unit (NCU) is associated with improved outcome. The first NCU in Korea was established on 15 March 2013. In Korea, the data of intensive care unit (ICU) outcome were collected in general ICUs, but there are only sparse data of NCU outcome. Hypothesis: The primary object of this study is to evaluate clinical outcomes of neurocritically ill patients in Korea. Methods: This study was conducted in 20 NCU beds of a large academic tertiary care hospital. We retrospectively analyzed the clinical data from neurocritically ill patients. A comparison was made between those patients admitted before and after the establishment of NCU. The primary outcome examined was ICU mortality. To evaluate functional outcome, the modified Rankin scale (mRS) at 6 months after NCU admission was obtained from medical records or telephone interview. Results: A total of 2487 patients were included, 1572 prior to and 915 after the establishment of NCU. The predominant admission cause were postoperative care and cerebrovascular disease; such as subarachnoid hemorrhage, malignant ischemic stroke, and intracerebral hemorrhage. There were no significant differences between the groups about demographic characteristics and admission Glasgow Coma Scale score. ICU mortality was significantly decreased in patients admitted to NCU (7.3% vs 4.7%, p=0.12). Admission to NCU also significantly decreased length of ICU stay and ventilator days. Among patient admitted NCU, 228 patients (48.1%) showed good functional recovery (mRS 0-2), while 245 patients (51.9%) had unfavorable outcomes (mRS 3-6). Conclusion: This is the first report about outcomes of neurocritically ill patients who admitted to NCU in Korea. Admission to specialized NCU and cared by neurointensivist improved outcomes and decreased ICU mortality.