ArticleIntensive care medicine2013
The effect of secular trends and specialist neurocritical care on mortality for patients with intracerebral haemorrhage, myasthenia gravis and Guillain-Barré syndrome admitted to critical care : an analysis of the Intensive Care National Audit & Research Centre (ICNARC) national United Kingdom database.
Article in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Consensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care : a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.Intensive care medicine · 2014Guideline
- Dynamics of serum testosterone and biological aging in men: insights from Chinese, American, and British populations.EClinicalMedicine · 2025Article
- Outcomes of myasthenia gravis patients admitted to the Intensive Care Unit: Experience from a tertiary care center in Saudi Arabia.PloS one · 2025Article
- Clinical Characteristics and Prognosis of ICU-Admitted Patients with Guillain-Barre Syndrome: A Report from a Large Teaching Hospital in South Iran.Iranian journal of medical sciences · 2024Article
- Weaning and extubation failure in myasthenic crisis: a multicenter analysis.Journal of neurology · 2024Article
- Trend of Intensive Care Unit Admission in Neurology-Neurosurgery Adult Patients in South Korea : A Nationwide Population-Based Cohort Study.Journal of Korean Neurosurgical Society · 2024Article
- Mortality of myasthenia gravis: a national population-based study in China.Annals of clinical and translational neurology · 2023Article
- Mortality Following Diagnosis of Nontraumatic Intracerebral Hemorrhage Within an Integrated "Hub-and-Spoke" Neuroscience Care Model: Is Spoke Presentation Noninferior to Hub Presentation?Neurocritical care · 2023Article
- Clinical features and outcomes of patients with myasthenia gravis admitted to an intensive care unit: A 20-year retrospective study.The Southern African journal of critical care : the official journal of the Critical Care Society · 2023Article
- Incidence, prevalence and disability associated with neurological disorders in Italy between 1990 and 2019: an analysis based on the Global Burden of Disease Study 2019.Journal of neurology · 2022Article
- Outcome of neurocritical disorders, a multicenter prospective cross-sectional study.Brain and behavior · 2022Article
- Sex differences in Guillain Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy and experimental autoimmune neuritis.Frontiers in immunology · 2022Review
- A scoping review of registry captured indicators for evaluating quality of critical care in ICU.Journal of intensive care · 2021Article
- Prolonged Ventilatory Support for Patients Recovering From Guillain-Barré Syndrome.Neurology. Clinical practice · 2021Article
- Effect of Early Tracheostomy on Mortality of Mechanically Ventilated Patients with Guillain-Barré Syndrome: A Nationwide Observational Study.Neurocritical care · 2020Observational
- Research in the Acute Rehabilitation Setting: a Bridge Too Far?Current neurology and neuroscience reports · 2019Review
- SOP myasthenic crisis.Neurological research and practice · 2019Article
- Impact of Recent Studies for the Treatment of Intracerebral Hemorrhage.Current neurology and neuroscience reports · 2018Review
- Zika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis.Journal of critical care · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo analyse mortality for spontaneous intracerebral haemorrhage (ICH), myasthenia gravis (MG) and Guillain-Barré syndrome (GBS) from 1996 to 2009 in UK intensive care units (ICUs).
methodsWe used the Intensive Care National Audit & Research Centre (ICNARC) database. We identified specialised neurosciences critical care units (NCCUs) (n = 16), general ICUs with full neurological support (n = 48) and general ICUs with limited neurological support (n = 138) and undertook descriptive analyses for each condition. Poisson regression was used to identify trends in admission rates, median regression to identify trends in lengths of stay (LOS), and logistic regression (Wald test) to analyse interaction between unit type and time period; odds ratios were calculated for hospital mortality associated with unit types.
resultsFor ICH (n = 10,313 cases), overall ICU mortality was 42.4 %, and acute hospital mortality 62.1 %. In NCCU, LOS was longer, but mortality lower, and over time, mortality from ICH decreased faster. For MG (n = 1,064 cases) and GBS (n = 1,906 cases), overall mortality was relatively high (MG: 8.7 % ICU mortality and 22 % acute hospital mortality; GBS: 7.7 and 16.7 %, respectively); overall mortality did not decrease over time.
conclusionsThis first large-scale analysis of outcomes in acute neurological disease in the UK demonstrates real-life mortality higher than published series. NCCU care is associated with increased survival in conditions requiring highly specialised intensive care techniques, but high-quality step-down care is pivotal in others. Strategies that truly improve outcomes must integrate emergency department management, ICU admission criteria, NCCU treatment, high-quality step-down care and neurorehabilitation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.