Morbidity and Mortality Patterns among Neurological Patients in the Intensive Care Unit of a Tertiary Health Facility

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 \u2013 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.Introduction/Objectif: La morbidit\ue9 et la mortalit\ue9 des malades neurologiques trait\ue9s dans le Service de soins intensifs a montr\ue9 les causes des troubles neurologiques et l'efficacit\ue9 de la prise en charge. M\ue9thodes: La tendance de la morbidit\ue9 et de la mortalit\ue9 des malades neurologiques admis dans le service des soins intensifs du centre hospitalier universitaire du Benin (CHUB), un centre de la sente tertiaire au Nigeria, a \ue9t\ue9 \ue9tudi\ue9 au cours d'une p\ue9riode de 10 ans (janvier 1985 au d\ue9cembre 2003). Un plan de sondage complet a \ue9t\ue9 utilis\ue9 avec tous les dossiers des patients \ue9tudi\ue9s. R\ue9sultats: Un total de 187 patients, (16,6% du total des admissions ICU) atteints de la morbidit\ue9 neurologique ont \ue9t\ue9 admis au cours de la p\ue9riode. Nous avons not\ue9 que le taux de la morbidit\ue9 est \ue9lev\ue9 pour les \ue9tiologies \ue9vitables \u2013 blessures de t\ueate (119 patients recens\ue9s en 63,7%) ; le t\ue9tanos (26 malades recens\ue9s en 13,9%) ; hypertension enc\ue9phalopathie (12 malades recens\ue9s en 6,4%) et la m\ue9ningite (8 malades recens\ue9s en 4,8%) ; Le taux du cas de la fatalit\ue9 pour ces causes \ue9taient 50,4%, 61,5%, 66,7% et 62,5% respectivement. Le taux du cas de la fatalit\ue9 pour la fi\ue8vre c\ue9r\ue9brale \ue9tait 100%. En outre, sexe masculin (67,9(%) \ue9taient plus susceptibles d'avoir des traumatismes li\ue9s \ue0 la morbidit\ue9 (p<0,001) que chez le sexe f\ue9minin (32,1%). Dans l'ensemble, le taux de la mortalit\ue9 \ue9tait \ue9lev\ue9 (52,4%) et demande une attention d'urgence. Conclusion: Nous avons conclu que des morbidit\ue9s \ue9vitables (blessures \ue0 la t\ueate, le t\ue9tanos, la m\ue9ningite et hypertendus enc\ue9phalopathie) constituaient pour la fatalit\ue9 parmi des malades neurologiques \ue0 ICH, Benin, Nig\ue9ria. La mortalit\ue9 \ue9tait plus \ue9lev\ue9e chez ceux que ont besoin d'une intervention intensive significative. Am\ue9lioration dans la sensibilisation du publique, la l\ue9gislation sur la circulation rapide, les soins m\ue9dicaux d'urgence et de la vaccination contre le t\ue9tanos et la m\ue9ningite devrait permettre de r\ue9duire la morbidit\ue9 et la mortalit\ue9