Do patients in a medical or surgical ICU benefit from a neurologic consultation?

Manoj K. Mittal, Rahul Kashyap, Vitaly Herasevich, Alejandro A. Rabinstein, Eelco F.M. Wijdicks

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Neurological complications are common in general medical and surgical intensive care units (ICU); they can prolong ICU and hospital stay and worsen outcome, including mortality. We performed a descriptive analysis of neurological consultations in non-neurological ICUs to determine the frequency of various neurological complications and to assess the diagnostic yield, therapeutic implications and prognostic benefit of these consultations. This is a retrospective single group cohort study of all neurological consultations for patients admitted to non-neurological (medical, respiratory care unit, cardiac, cardiothoracic, surgical and trauma) ICUs at Saint Marys Hospital (Mayo Clinic, Rochester) over a 24-month period (01 January 2010 to 31 December 2011). Equal numbers of neurological consultations (174, 50% each) were requested from medical ICUs and surgical ICUs. Altered consciousness (158, 45%), seizure (76, 22%) and focal deficits (75, 22%) were the most common reasons for consultations. Diagnostic, prognostic and therapeutic benefit was considered present in 89%, 38% and 39% patients respectively. Treatment change following neurological consultation occurred in 48% patients. Encephalopathy, stroke, seizure and anoxic brain injury were the most common causes of neurological complications in non-neurological ICUs with sedatives and opiates being the most common cause of encephalopathy. Almost half of the patients had change in treatment following neurological consultation. Neurological consultations in non-neurological ICU's are beneficial for patient's care in terms of diagnosis, treatment and prognosis.

Original languageEnglish (US)
Pages (from-to)512-520
Number of pages9
JournalInternational Journal of Neuroscience
Volume125
Issue number7
DOIs
StatePublished - Jul 3 2015

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Keywords

  • Neurology
  • benefit
  • consultation
  • intensive care unit

ASJC Scopus subject areas

  • Neuroscience(all)

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