The Incidence, Characteristics, and Outcomes of Stroke and Seizure In Critically Ill Surgical Patients: A Multicenter Cohort Study of Thai Surgical Intensive Care Units (THAI-SICU Study)
Siriporn Siraklow MD*1, Konlawij Trongtrakul MD*2, Kaweesak Chittawatanarat MD, PhD*3, Chompunoot Pathonsamit MD*1, Tanawadee Teeratchanan MD*1, Sujaree Poopipatpab MD*1, the THAI-SICU study group
Affiliation : *1 Department of Anesthesiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand *2 Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand *3 Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To explore the incidence, characteristics, and outcomes of patients affected with new onset of stroke and seizure in
the surgical intensive care unit (SICU).
Material and Method: This study identified new onset of stroke and seizure in 4,652 patients admitted to our multicenter
prospective cohort study, a collaboration of nine university-affiliated surgical ICUs in Thailand between April 2011 to
January 2013.
Results : The authors found new stroke and seizure events at 0.2% and 1%, respectively. The significant characteristics found
in stroke and seizure patients included: reason for ICU admission, American Society of Anesthesiologists (ASA) physical
status classification, and severity of patients at ICU admission (evaluated by APACHE-II and SOFA day score in first 24 hours
of ICU admission). In terms of outcomes, there was higher ICU mortality in both stroke and seizure groups than in non-
stroke and non-seizure groups (18% vs. 36% vs. 9%, p<0.001, respectively). In addition, ICU length of stay among stroke
and seizure patients was also longer than non-stroke and non-seizure groups (6 (4-18) vs. 10 (4-16) vs. 2 (1-4) days,
p<0.001, respectively). However, multivariable regression analysis showed a statistical significance only in longer duration
of ICU stay in stroke (6.07 days; 95% CI: 3.34-8.80) and seizure (3.88 days; 95% CI: 2.15-5.62) when compared with non-
stroke and non-seizure patients, adjusted by ASA, APACHE-II and SOFA score).
Conclusion : From Thai-SICUs study, patients admitted to surgical ICU who developed new episodes of stroke and seizure
had longer ICU length of stay when adjusted by their severity score.
Keywords : Stroke, Seizure, Surgical intensive care unit, Mortality rate, ICU length of stay
