Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1
Introduction Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patie...
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| Veröffentlicht in: | Neurocritical care Jg. 32; H. 1; S. 172 - 179 |
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| Hauptverfasser: | , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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New York
Springer US
01.02.2020
Springer Nature B.V |
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| ISSN: | 1541-6933, 1556-0961, 1556-0961 |
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| Abstract | Introduction
Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study).
Methods
In this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal–Wallis test followed by the Dunn procedure to test for differences in practices among world regions.
Results
We analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%).
Conclusion
The PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care. |
|---|---|
| AbstractList | Introduction
Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study).
Methods
In this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal–Wallis test followed by the Dunn procedure to test for differences in practices among world regions.
Results
We analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%).
Conclusion
The PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care. IntroductionNeurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study).MethodsIn this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal–Wallis test followed by the Dunn procedure to test for differences in practices among world regions.ResultsWe analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%).ConclusionThe PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care. Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study). In this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal-Wallis test followed by the Dunn procedure to test for differences in practices among world regions. We analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%). The PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care. Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study).INTRODUCTIONNeurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However, there is a lack of data that describe the scope of practice of neurointensivists and epidemiological data on the types of patients and treatments used in neurocritical care units worldwide. To address these issues, we designed a multicenter, international, point-prevalence, cross-sectional, prospective, observational, non-interventional study in the setting of neurocritical care (PRINCE Study).In this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal-Wallis test followed by the Dunn procedure to test for differences in practices among world regions.METHODSIn this manuscript, we analyzed data from the initial phase of the study that included registration, hospital, and intensive care unit (ICU) organizations. We present here descriptive statistics to summarize data from the registration case report form. We performed the Kruskal-Wallis test followed by the Dunn procedure to test for differences in practices among world regions.We analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%).RESULTSWe analyzed information submitted by 257 participating sites from 47 countries. The majority of those sites, 119 (46.3%), were in North America, 44 (17.2%) in Europe, 34 (13.3%) in Asia, 9 (3.5%) in the Middle East, 34 (13.3%) in Latin America, and 14 (5.5%) in Oceania. Most ICUs are from academic institutions (73.4%) located in large urban centers (44% > 1 million inhabitants). We found significant differences in hospital and ICU organization, resource allocation, and use of patient management protocols. The highest nursing/patient ratio was in Oceania (100% 1:1). Dedicated Advanced Practiced Providers are mostly present in North America (73.7%) and are uncommon in Oceania (7.7%) and the Middle East (0%). The presence of dedicated respiratory therapist is common in North America (85%), Middle East (85%), and Latin America (84%) but less common in Europe (26%) and Oceania (7.7%). The presence of dedicated pharmacist is highest in North America (89%) and Oceania (85%) and least common in Latin America (38%). The majority of respondents reported having a dedicated neuro-ICU (67% overall; highest in North America: 82%; and lowest in Oceania: 14%).The PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care.CONCLUSIONThe PRINCE Study results suggest that there is significant variability in the delivery of neurocritical care. The study also shows it is feasible to undertake international collaborations to gather global data about the practice of neurocritical care. |
| Author | Taccone, Fabio Silvio Georgiadis, Alexandros Oddo, Mauro Venkatasubba Rao, Chethan P. Martin, Renee H. Sung, Gene Suarez, Jose I. Bauza, Colleen Calvillo, Eusebia Hemphill, J. Claude LeRoux, Peter D. |
| Author_xml | – sequence: 1 givenname: Jose I. orcidid: 0000-0003-0548-9936 surname: Suarez fullname: Suarez, Jose I. email: jsuarez5@jhmi.edu organization: Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Neurology, Neurosurgery, Johns Hopkins University School of Medicine – sequence: 2 givenname: Renee H. surname: Martin fullname: Martin, Renee H. organization: Medical University of South Carolina – sequence: 3 givenname: Colleen surname: Bauza fullname: Bauza, Colleen organization: Department of Health Informatics, Johns Hopkins All Children’s Hospital – sequence: 4 givenname: Alexandros surname: Georgiadis fullname: Georgiadis, Alexandros organization: UDivision of Vascular Neurology and Neurocritical Care, Baylor College of Medicine and CHI Baylor St. Luke’s Medical Center – sequence: 5 givenname: Chethan P. surname: Venkatasubba Rao fullname: Venkatasubba Rao, Chethan P. organization: UDivision of Vascular Neurology and Neurocritical Care, Baylor College of Medicine and CHI Baylor St. Luke’s Medical Center – sequence: 6 givenname: Eusebia surname: Calvillo fullname: Calvillo, Eusebia organization: Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Neurology, Neurosurgery, Johns Hopkins University School of Medicine – sequence: 7 givenname: J. Claude surname: Hemphill fullname: Hemphill, J. Claude organization: University of California San Francisco – sequence: 8 givenname: Gene surname: Sung fullname: Sung, Gene organization: University of Southern California – sequence: 9 givenname: Mauro surname: Oddo fullname: Oddo, Mauro organization: CHUV Lausanne University Hospital – sequence: 10 givenname: Fabio Silvio surname: Taccone fullname: Taccone, Fabio Silvio organization: Erasme Hospital and Free University of Brussels – sequence: 11 givenname: Peter D. surname: LeRoux fullname: LeRoux, Peter D. organization: Main Line Health Care |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31175567$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1097/01.CCM.0000208360.70835.87 10.1385/NCC:5:2:166 10.1093/bja/aeh275 10.1186/cc6984 10.1016/S2213-2600(14)70061-X 10.1002/ana.410320413 10.1007/s12028-011-9612-x 10.1007/s12028-018-0598-5 10.1385/NCC:5:2:159 10.1016/S0140-6736(10)60446-1 10.1097/MCC.0b013e32808255c6 10.1016/j.jbi.2008.08.010 |
| ContentType | Journal Article |
| Contributor | Venkatasubba Rao, Chethan P Kramer, Andreas Miller, Angela Lacerda Gallardo, Angel J Bhonagiri, Deepak Zahrani, Amer Rashed Al Herrera, Edgar Avalos Salgado, Estuardo Basignani, Cherlynn Laskowitz, Daniel T Sanchez, Baltasar Chan, Alexander Singares, Eduardo Smith Graffagnino, Carmelo Yarad, Elizabeth Harvey, Daniel Barge, Deborah Kern, Alexander Georgiadis, Alexandros Schiefecker, Alois Jabbary, Ahmed Al Jenkinson, Elizabeth Romero, Carlos Emanuel, Benjamin Gil, Bladimir Francis, Brandon McArthur, Colin Nair, Deepak Coronel, Ermitaño Bautista Giraldo, Elias A Milzman, Dave Chang, Cherylee Kim, Anthony Chaudhry, Burhan Deeb, Ahmad M Calvillo, Eusebia Bautista, Diego Nathan, Barnett Almemari, Ayesha Katila, Ari Sarwal, Aarti Misiewska-Kaczur, Agnieszka Nazliel, Bijen Williamson, Craig Perez, Diego Manno, Edward McCrum, Barbara Lazaridis, Christos Berghe, Caroline Malek, Ali Fathy, Ahmed Naidech, Andrew Pfaulser, Bettina Bradford, Celia Aneman, Anders Layon, A J Hobohm, Carsten Roberts, Brigit Jordan, Dedrick Roberts, Debra Miller, David W Hassan, |
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| Copyright | Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019 Copyright Springer Nature B.V. Feb 2020 |
| Copyright_xml | – notice: Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019 – notice: Copyright Springer Nature B.V. Feb 2020 |
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| Keywords | Prospective Critical care Observational study Neurocritical care Outcomes |
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Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few... Neurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few years. However,... IntroductionNeurocritical care focuses on the care of critically ill patients with an acute neurologic disorder and has grown significantly in the past few... |
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| Title | Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1 |
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