A comparative analysis of neurocritical care in dedicated versus nondedicated ICUs Article Swipe
YOU?
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· 2025
· Open Access
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· DOI: https://doi.org/10.4103/roaic.roaic_33_25
· OA: W4414203261
Background Patients with primary neurocritical disorders often require complex, multidisciplinary care. Variability in ICU structure and protocols poses challenges to standardizing care and evaluating outcomes. This study aims to describe the characteristics and compare outcomes between admissions to dedicated neurocritical care units (NCCUs) and nondedicated ICUs among these patients. Patients and methods A prospective observational study was conducted at Alexandria University Hospitals from December 2023 to May 2024. A total of 450 patients with primary neurological disorders were included. Patients were grouped by ICU type: NCCUs ( n =211) and nondedicated ICUs ( n =239). Demographic, clinical, and outcome data were collected and analyzed using descriptive and comparative statistics. Results Both cohorts were comparable in demographic and baseline clinical characteristics. However, patients admitted to dedicated NCCUs had significantly lower mortality (11.3 vs. 38%, P <0.001) and better functional outcomes at ICU discharge. A higher proportion of patients in nondedicated ICUs were discharged with a modified Rankin Scale score of 5–6, indicating severe disability or dependence, compared with dedicated NCCUs (50.2 vs. 36%, P =0.002). Due to discrepancy in the frequency of the primary diagnosis between both ICUs, disease-specific severity and mortality was calculated, and showed significantly better outcomes for patients admitted to NCCUs with acute ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage, P :0.001, 0.03, 0.001, respectively. Conclusion Admission to a dedicated NCCU was associated with significantly improved survival and functional outcomes. These findings highlight the importance of specialized neurocritical care services and provide evidence to support investment in expanding NCCU capacity in resource-limited settings.
