Morbidity and mortality patterns among neurological patients in the intensive care unit of a tertiary health facility

Abstract

Background/objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management.

Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin Teaching Hospital (UBTH), a tertiary health institution in Nigeria, was examined over an 18-year period (January 1985 to December 2003). A complete sampling frame was used with all patients' records scrutinized.

Results: A total of 187 patients, (16.6% of the total ICU admissions) with neurological morbidity were admitted during the period. We observed that morbidity was high for preventable etiologies--head injury (119 patients constituting 63.7%), tetanus (26 patients constituting 13.9%), hypertensive encephalopathy (12 patients constituting 6.4%) and meningitis (8 patients constituting 4.8%). The case fatality rates for these causes were 50.4%, 61.5%, 66.7% and 62.5% respectively. The case fatality rate for cerebral malaria was 100%. In addition, males (67.9%) were more likely to have trauma-related morbidity (P < .001) than females (32.1%). Overall mortality rate was high (52.4%) and calls for urgent attention.

Conclusion: We concluded that preventable morbidities (head injury, tetanus, meningitis and hypertensive encephalopathy) accounted for fatality among neurological patients in the ICU, Benin City, Nigeria. Mortality was higher among those that required significant intensive interventions. Improved public awareness, traffic legislation, prompt emergency medical care and immunization against tetanus and meningitis should reduce morbidity and mortality.