Neurologic complications of critical medical illnesses

Thomas P Bleck*, M. C. Smith, S. J.C. Pierre-Louis, J. J. Jares, J. Murray, C. A. Hansen

*Corresponding author for this work

Research output: Contribution to journalArticle

195 Scopus citations

Abstract

Objectives: To identify the neurologic complications of critical medical illnesses, and to assess their effect on mortality rates and on medical ICU and hospital lengths of stay. Design: Prospective clinical evaluation of all medical ICU admissions for 2 yrs. Setting: A 14-bed, general medical intensive and coronary care unit in a large university hospital. Patients: Patients (n = 1,850) admitted to the hospital, of whom 92 were admitted for primarily neurologic problems. Of the remaining 1,758 patients, 217 (12.3%) experienced a neurologic complication. Interventions: None. Measurements and Main Results: Patients developing a neurologic complication while in the medical ICU demonstrated an increased risk of inhospital mortality when compared with patients who did not suffer such problems (45.7% vs. 26.6%; p < .00001). Patients with neurologic complications experienced 2.5-fold longer medical ICU stay times (p < .001) and almost two-fold longer hospital stay times (p < .001). Metabolic encephalopathy, seizures, hypoxic-ischemic encephalopathy, and stroke were the most common complications. Sepsis was the most frequent cause of encephalopathy, and cerebrovascular lesions were the most common cause of seizures. Formal neurologic consultations were requested in only 36% of these patients. Conclusions: Neurologic complications are associated with increased mortality rates and longer medical ICU and hospital lengths of stay. These conditions are probably underrecognized at present. ICUs have the potential to serve as environments for neurologic teaching and research.

Original languageEnglish (US)
Pages (from-to)98-103
Number of pages6
JournalCritical care medicine
Volume21
Issue number1
DOIs
StatePublished - Jan 1 1993

Keywords

  • brain injury
  • critical care
  • intensive care
  • metabolic encephalopathy
  • neurologic complication
  • neurologic emergencies
  • neurology
  • neuropathy
  • seizure
  • sepsis
  • stroke

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Bleck, T. P., Smith, M. C., Pierre-Louis, S. J. C., Jares, J. J., Murray, J., & Hansen, C. A. (1993). Neurologic complications of critical medical illnesses. Critical care medicine, 21(1), 98-103. https://doi.org/10.1097/00003246-199301000-00019