Document Detail

Extracranial complications in patients with acute brain injury: a post-hoc analysis of the SOAP study.
MedLine Citation:
PMID:  18175107     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the incidence and severity of nonneurological organ dysfunction and its effect on outcome in acute neurological patients in an international cohort observational study. DESIGN AND SETTING: Analysis of database from the observational Sepsis Occurrence in Acutely Ill Patients (SOAP) study in 198 intensive care units (ICUs) in 24 European countries. PATIENTS: All adult patients admitted to the participating ICUs between 1 and 15 May 2002. Of the 3,147 patients in the SOAP database 373 (12%) were admitted with a neurological diagnosis, including 154 (41%) with traumatic brain injury and 186 (50%) with cerebrovascular accident. MEASUREMENTS AND RESULTS: Patients were followed until death, hospital discharge, or for 60 days. Neurological patients were younger and had a higher incidence of trauma and fewer comorbidities than nonneurological patients. Neurological patients developed ICU-acquired sepsis and respiratory failure more frequently than the other patients. ICU and hospital mortality rates were higher and ICU length of stay longer in neurological than in nonneurological patients. Multivariate logistic analysis showed that, in addition to the Glasgow Coma Score (GCS) and the presence of nontraumatic brain injury, cardiovascular failure, hepatic failure, and ALI/ARDS were the only factors independently associated with a higher risk of death in the ICU in patients with a neurological diagnosis. CONCLUSIONS: Although neurological patients were younger and had fewer comorbidities, they developed ICU-acquired sepsis and respiratory failure more frequently than other patients. Efforts should be oriented to reduce cardiovascular, hepatic, and respiratory complications.
Luciana Mascia; Yasser Sakr; Daniela Pasero; Didier Payen; Konrad Reinhart; Jean-Louis Vincent;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-01-04
Journal Detail:
Title:  Intensive care medicine     Volume:  34     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-24     Completed Date:  2008-10-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  720-7     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, University of Turin, Ospedale S. Giovanni Battista, Corso Dogliotti 14, 10126, Turin, Italy.
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MeSH Terms
Brain Injuries / complications*
Case-Control Studies
Europe / epidemiology
Intensive Care Units
Logistic Models
Middle Aged
Multiple Organ Failure / epidemiology*,  etiology
Multivariate Analysis
Prospective Studies
Respiratory Distress Syndrome, Adult / epidemiology*,  etiology
Stroke / complications*
Systemic Inflammatory Response Syndrome / epidemiology*,  etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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