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ISSN: 1642-5758
Anaesthesiology Intensive Therapy
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2/2024
vol. 56
 
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abstract:
Original article

The impact of neurocritical patient transfer on outcomes: retrospective analysis of practice in the largest neurosurgical centre in Lithuania

Greta Kasputytė
1, 2
,
Marija Jakiševaitė
3
,
Augustė Žurauskaitė
3
,
Aurika Karbonskienė
2
,
Milda Švagždienė
1, 2
,
Birutė Kumpaitienė
4
,
Neringa Balčiūnienė
5
,
Tomas Tamošuitis
5

  1. Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
  2. Department of Anaesthesiology, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
  3. Department of Medicine, Faculty of Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
  4. Department of Disaster Medicine, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
  5. Department of Intensive Care, Medical Academy, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
Anaesthesiol Intensive Ther 2024; 56, 2: 146–150
DOI: https://doi.org/10.5114/ait.2024.141342
Online publish date: 2024/07/23
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Introduction:
Critical neurological conditions require urgent assessment and treatment. The quality of care and treatment provided during the transportation is important and related to the outcome of critically ill patients. We aimed to assess the quality of interhospital transportation of neurocritical patients in the largest neurosurgical cluster in Lithuania and identify possible outcome prediction variables.

Material and methods:
A retrospective cohort study was conducted. We analysed the data from 106 neurocritical patients who were transported to the Hospital of Lithuanian University of Health Sciences Kaunas Clinics Neurosurgery Clinic in 2018. We collected the needed data from patients’ medical history, referrals, and transfer sheets. In our research, we evaluated the quality of referrals and the quality of filling protocols.

Results:
The transportation protocols showed that during the transferrals diuresis, end-tidal carbon dioxide (ETCO2), pupil size, and reaction to light were not routinely measured in any of the patients, as opposed to other vital signs. We found that less than half of referrals (42%) were informative and suitable for sending the patient to another hospital. Results showed that the first systolic arterial blood pressure (sABP) measured at Neuro-ICU is associated with patient outcomes. Higher sABP was seen in the group of patients with negative outcomes (death, continued need for care).

Conclusions:
This study demonstrated that monitoring of vital signs and neurological parameters as well as the quality of referrals were found to be the weakest links in the neurocritical patient transfer.

keywords:

critical illness, neurosurgery, intensive care unit
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