Neurologic disorders in a medical intensive care unit: A prospective survey

Abstract

Acute neurologic disorders are frequent and important in medical intensive care unit (MICU) patients, occurring in 45% of 100 consecutive patients. Neurologic complications occurred in 33% of patients admitted for non-neurologic reasons and necessitated cranial computed tomography in 36%. Approximately half (48%) of the secondary neurologic disorders were managed without neurologic consultation. The mortality rate in patients with secondary neurologic disorders was 59% (16 of 27) compared with a rate of 20% (11 of 55) in patients without neurologic complications ( P < .001). Potentially important neurologic signs were unrecognized by non-neurologists in three patients, 7% of those patients with active neurologic disorders. Special training and expertise in the field of neurology may be optimal in physicians specializing in MICU care.