Produção Nacional
Revisado por pares
Epidemiology and disease burden of patients requiring neurocritical care: a Brazilian multicentre cohort study
2023; Nature Portfolio; Volume: 13; Issue: 1 Linguagem: Inglês
10.1038/s41598-023-44261-w
ISSN2045-2322
AutoresÁlvaro Réa-Neto, Rafaella Stradiotto Bernardelli, Mirella Cristine de Oliveira, Paula Geraldes David-João, Amanda Christina Kozesinski-Nakatani, Antônio Luís Eiras Falcão, Pedro Kurtz, Hélio Afonso Ghizoni Teive, Fabíola Prior Caltabeloti, Salomón Soriano, Viviane Cordeiro Veiga, Fernando A. Bozza, Luana Alves Tannous, Juliano Gasparetto, Fernanda Sampaio Alves, José Arthur Santos Brasil, Glécia Carla Rocha, Jarbas Motta, Bruna Martins Dzivielevski Câmara, Livia Rodrigues Figueiredo, Janaína Oliveira, William Nascimento Vianna, Diogo Roberto Lorenzo Iglesias, Rafael Alexandre de Oliveira Deucher, Gloria Martins, Marcel Resende Lopes, Frederico Bruzzi de Carvalho, Jorge Luiz da Rocha Paranhos, Ulysses Vasconcellos de Andrade e Silva, Marco Oliveira Py, Fernanda Baeumle Reese, Marcos Freitas Knibel, Gustavo Cartaxo Patriota, Suzana Margareth Lobo, Mario Roberto Rezende Guimarães, Luciana de Oliveira Neves, Antônio Fagundes, Ary Serpa Neto, Walter C. G. Baptista, Cíntia Magalhães Carvalho Grion, Péricles Almeida Delfino Duarte, B. Castelo Branco, Luísa da Silva André Salgado, Nívea Melo de Souza Costa, Danilo Bastos Pompermayer, Anna Flavia Kaled, Rafael Torres Brum, Alessandro Rocha Milan de Souza, J Fuck, Cláudio Piras,
Tópico(s)Cardiac Arrest and Resuscitation
ResumoAbstract Acute neurological emergencies are highly prevalent in intensive care units (ICUs) and impose a substantial burden on patients. This study aims to describe the epidemiology of patients requiring neurocritical care in Brazil, and their differences based on primary acute neurological diagnoses and to identify predictors of mortality and unfavourable outcomes, along with the disease burden of each condition at intensive care unit admission. This prospective cohort study included patients requiring neurocritical care admitted to 36 ICUs in four Brazilian regions who were followed for 30 days or until ICU discharge (Aug-Sep in 2018, 1 month). Of 4245 patients admitted to the participating ICUs, 1194 (28.1%) were patients with acute neurological disorders requiring neurocritical care and were included. Patients requiring neurocritical care had a mean mortality rate 1.7 times higher than ICU patients not requiring neurocritical care (17.21% versus 10.1%, respectively). Older age, emergency admission, higher number of potential secondary injuries, and worse APACHE II, SAPS III, SOFA, and Glasgow coma scale scores on ICU admission are independent predictors of mortality and poor outcome among patients with acute neurological diagnoses. The estimated total DALYs were 4482.94 in the overall cohort, and the diagnosis with the highest DALYs was traumatic brain injury (1634.42). Clinical, epidemiological, treatment, and ICU outcome characteristics vary according to the primary neurologic diagnosis. Advanced age, a lower GCS score and a higher number of potential secondary injuries are independent predictors of mortality and unfavourable outcomes in patients requiring neurocritical care. The findings of this study are essential to guide education policies, prevention, and treatment of severe acute neurocritical diseases.
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