Donovan, J; Glover, A; Gregson, J; Hitchings, AW; Wall, EC; Heyderman, RS
(2024)
A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020.
BMC Infect Dis, 24 (1).
p. 132.
ISSN 1471-2334
https://doi.org/10.1186/s12879-024-08976-z
SGUL Authors: Hitchings, Andrew William
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Abstract
BACKGROUND: Neurological infection is an important cause of critical illness, yet little is known on the epidemiology of neurological infections requiring critical care. METHODS: We analysed data on all adults with proven or probable neurological infection admitted to UK (NHS) critical care units between 2001 and 2020 reported to the Intensive Care National Audit and Research Centre. Diagnoses, physiological variables, organ support and clinical outcomes were analysed over the whole period, and for consecutive 5-year intervals within it. Predictors of in-hospital mortality were identified using a backward stepwise regression model. RESULTS: We identified 20,178 critical care admissions for neurological infection. Encephalitis was the most frequent presentation to critical care, comprising 6725 (33.3%) of 20,178 cases. Meningitis- bacterial, viral or unspecified cases - accounted for 10,056 (49.8%) of cases. In-hospital mortality was high, at 3945/19,765 (20.0%) overall. Over the four consecutive 5-year periods, there were trends towards higher Glasgow Coma Scale scores on admission, longer critical care admissions (from median 4 [IQR 2-8] to 5 days [IQR 2-10]), and reduced in-hospital mortality (from 24.9 to 18.1%). We identified 12 independent predictors of in-hospital death which when used together showed good discrimination between patients who die and those who survive (AUC = 0.79). CONCLUSIONS: Admissions with neurological infection to UK critical care services are increasing and the mortality, although improving, remains high. To further improve outcomes from severe neurological infection, novel approaches to the evaluation of risk stratification, monitoring and management strategies are required.
Item Type: | Article | ||||||
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Additional Information: | © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. | ||||||
Keywords: | Adults, Critical care, Encephalitis, Meningitis, Neurological infection, Adult, Humans, Retrospective Studies, Hospital Mortality, Hospitalization, Intensive Care Units, Critical Care, Communicable Diseases, Nervous System Diseases, United Kingdom, Humans, Communicable Diseases, Nervous System Diseases, Critical Care, Hospitalization, Hospital Mortality, Retrospective Studies, Adult, Intensive Care Units, United Kingdom, Neurological infection, Meningitis, Encephalitis, Critical care, Adults, 0605 Microbiology, 1103 Clinical Sciences, 1108 Medical Microbiology, Microbiology | ||||||
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical & Biomedical Education (IMBE) Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE ) |
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Journal or Publication Title: | BMC Infect Dis | ||||||
ISSN: | 1471-2334 | ||||||
Language: | eng | ||||||
Dates: |
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||
PubMed ID: | 38273223 | ||||||
Web of Science ID: | WOS:001151291100001 | ||||||
Go to PubMed abstract | |||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/116488 | ||||||
Publisher's version: | https://doi.org/10.1186/s12879-024-08976-z |
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