J Neurointensive Care.  2020 Oct;3(2):42-47. 10.32587/jnic.2020.00283.

Consultation Patterns of Neurosurgical Patients Admitted to Intensive Care Units Vary with Neurointensivist Co-management

• Cho H
• Lee YI
• Ryu JA

• KMID: 2555038
• DOI: http://doi.org/10.32587/jnic.2020.00283

Abstract

Objective
To evaluate the consultation patterns in the neurosurgical intensive care unit (ICU) and the neurointensivist factors that may influence consultations.
Methods
This was a retrospective, single-center, observational study of neurosurgical patients admitted to ICU from January 2013 to December 2019. In this study, only formal consultation was defined as the consultation, but curbside consultation was excluded.
Results
A total of 12,743 patients were analyzed in this study. Malignancy (54.6%) and hypertension (30.6%) were the most common comorbidities. Brain tumor (43.0%) and microvascular decompression (17.6%) were the most common reasons for ICU admission. Among total neurosurgical patients, 3,056 (24.0%) patients had 8,789 consultations during their ICU stay. The departments of Infectious disease (27.9%), Pediatrics (9.6%) and Rehabilitation (9.6%) were the three most frequently consulted specialties, accounting for up to 47.1% of all the consultations. The frequency of the consultations involving infectious disease and pediatric services except for permission to use restricted antibiotics, and consultation services involving neurology, pulmonology and respiratory care by respiratory therapists were reduced compared to levels before neurointensivist co-management. However, the consultations with otorhinolaryngologists, radiologists and endocrinologists were increased compared to levels after neurointensivist co-management. Consultations replied within 24h before initiation of neurointensivist co-management were increased.
Conclusions
In this study, we were able to identify an interesting consultation patterns of neurosurgical and neurocritically ill patients. Neurointensivist co-management may have an impact on the consultation under general and neurocritical management.

Keyword

Consultation; Neurosurgery; Intensive care unit