Clinical Characteristics, Critical Care Interventions and Outcomes of Paediatric Neuro-Intensive Care Unit Admissions - A Retrospective Cohort Study

Purpose There is limited literature regarding the burden, management and outcomes of children managed in the neuro-intensive care unit (NICU). Increasing paediatric NICU admissions presents a huge challenge in developing countries like India. The critical care interventions (CCIs) and clinical outcomes of children with neurological and neurosurgical pathologies may vary but are currently unknown. This study aimed to assess the incidence of paediatric NICU admission and compare the clinical characteristics, NICU management and clinical outcomes between paediatric neurological and neurosurgical populations in the NICU. Methods This retrospective observational study was conducted after institute ethics committee approval and involved children aged < 18 years admitted to the NICU of a tertiary care academic neurosciences hospital between January to December 2023. Results About 8% (90/1153) of NICU admissions were children. We observed significant differences in the number of CCIs during the NICU stay, duration of NICU stay, and the GCS score at NICU and hospital discharge between paediatric neurological and neurosurgical disorders. The frequency of CCIs correlated significantly with the duration of mechanical ventilation, NICU stay and hospital stay, and GCS score at NICU and hospital discharge. Conclusion Our study suggests that CCIs and clinical outcomes are different for paediatric neurological and neurosurgical patients, and the number of CCIs has a significant impact on clinical outcomes in children admitted to the NICU. Future studies should evaluate if a dedicated paediatric NICU influences outcomes in children with acute and severe neurological diseases.