To evaluate the effect of contiguous Neurosciences ICU admissions on in-hospital outcomes among neuroemergency patients.

Capacity strain in intensive care units has far-reaching implications for ICU operations and performance. Previous research has shown associations between resource strain and worse patient outcomes in critical care. A retrospective cohort study found that near-simultaneous general ICU admissions were significantly associated with hospital mortality, length of stay, and discharge disposition. There is limited literature on the association between contiguous admissions and patient outcomes in a neurocritical care setting. 

A retrospective analysis of all neuroemergency patients admitted within one hour of each other in an academic Neurosciences ICU from October 2018 to September 2019 was conducted. Primary patient outcomes included in-hospital mortality, hospital length of stay, and hospital discharge disposition (home vs facility). Fisher’s exact, Pearson’s chi-squared, and Wilcoxon-Mann-Whitney tests were used to determine the association between contiguous admissions and in-hospital mortality, discharge disposition, and hospital length of stay, respectively. Missing data was accounted for via complete case analysis.

Out of 365 neuroemergency patients, 13 pairs of patients were admitted within one hour of each other (n=26). 8% of patients who had near-simultaneous admission died in the hospital (n=2), whereas 17% of patients who did not have a near-simultaneous admission died in the hospital (n=39). 50% of the near-simultaneous group were discharged home (n=12), while only 35% of the control group were discharged home (n=66). The median length of stay was 11.65 days for those who had contiguous admissions (IQR=11.34) and 9.11 days for controls (IQR=12.57) Contiguous admission in the Neurosciences ICU was not significantly associated with in-hospital mortality (p=0.39), hospital length of stay (p=0.71), or hospital discharge disposition (p=0.18). 

Our preliminary results suggest that, in a neurocritical care setting, contiguous admissions are not associated with in-hospital mortality, length of stay, and discharge disposition.