TY - JOUR
T1 - Neurologic illness in Zambia
T2 - A neurointensivist's experience
AU - Brown, Merritt W.
AU - Foy, Katie Ellen
AU - Christopher, Chanda
AU - Mulundika, Jacqueline
AU - Koralnik, Igor J.
AU - Siddiqi, Omar K.
N1 - Publisher Copyright:
© 2017
PY - 2018/2/15
Y1 - 2018/2/15
N2 - Introduction Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. Methods From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia. We stratified each patient by demographics, presence of primary or secondary neurologic deficit, comorbidities, and outcome. Results Of the 33 patients seen during this period, 26 (78.8%) had a neurologic deficit. An equal number of patients carried a primary neurologic diagnosis (13) versus a secondary neurologic diagnosis (13). Primary neurologic disorders included spinal cord injury/tumor/abscess, intracranial hemorrhage, Guillain-Barre syndrome, and traumatic brain injury. Conclusions Over three-quarters of critically ill patients in the observation period carried a neurologic diagnosis. Future research should aim to identify if resource appropriate neurocritical care training of frontline providers may lead to improved clinical outcomes.
AB - Introduction Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. Methods From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia. We stratified each patient by demographics, presence of primary or secondary neurologic deficit, comorbidities, and outcome. Results Of the 33 patients seen during this period, 26 (78.8%) had a neurologic deficit. An equal number of patients carried a primary neurologic diagnosis (13) versus a secondary neurologic diagnosis (13). Primary neurologic disorders included spinal cord injury/tumor/abscess, intracranial hemorrhage, Guillain-Barre syndrome, and traumatic brain injury. Conclusions Over three-quarters of critically ill patients in the observation period carried a neurologic diagnosis. Future research should aim to identify if resource appropriate neurocritical care training of frontline providers may lead to improved clinical outcomes.
KW - International health
KW - International neurology
KW - Neurocritical care
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U2 - 10.1016/j.jns.2017.12.031
DO - 10.1016/j.jns.2017.12.031
M3 - Article
C2 - 29406894
AN - SCOPUS:85039850751
SN - 0022-510X
VL - 385
SP - 140
EP - 143
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
ER -