Factors Influencing Length of Stay in Neurosurgical Intensive Care Unit
Kanya Kumwilaisak MD*, Oranuch Kyokong MD*, Toonchai Indrambarya MD*
Affiliation : * Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok
Background : The demand of occupancy in neurosurgical intensive care unit (NICU) has extremely risen up in
King Chulalongkorn Memorial Hospital but the intensive care personnel have not proportionally increased
with the demand identifying especially for intensivists. The possible management that may be help to solve this
problem is identifying the factors which may be involved in prolonging length of stay (LOS) in ICU and
modifying of those risk factors.
Objective : To determine the factors which influenced the LOS in NICU.
Results : Neurosurgical intensive care unit (NICU) in King Chulalongkorn Memorial Hospital which is the
tertiary care hospital.
Research design: A retrospective observational study
Material and Method: All data of NICU had been gathered over the period of October 1st, 2004 to December
31st, 2004. The patient characteristics; age, gender, diagnosis, underlying diseases, and length of NICU stay
were recorded. Postoperative events were stratified into 4 groups involving pulmonary complications,
cardiovascular complications, neurological conditions and others.
Results : A total of 178 admissions utilized 605 ICU days. Short-stay patients (LOS < 3 days) accounted for
76.4% of total admissions which consumed only 32.1% of ICU days. The patients who were admitted between
3 to 14 days had 20.8% but mostly utilized 49.4% of ICU day. Cerebral aneurysm had the highest proportion
(41.03%) in LOS more than 3 days group. The major causes of prolonged LOS are triple-H therapy (28%) and
mechanical ventilation assisting (28%).
Conclusion : The major causes of prolonged LOS are triple-H therapy and mechanical ventilation assisting in
neurosurgical ICU. Early tracheotomy and using the proper weaning protocol might help reducing LOS in
ICU with limited specific care procedure.
Keywords : Length of stay (LOS), Intensive care units (ICUs), Neurosurgery
