The development of neurocritical care in China from the perspective of evaluation and treatment of critical neurological diseases

Yingying Su; Junfang Teng; Fei Tian; Jing Jing; Huijin Huang; Suyue Pan; Wen Jiang; Furong Wang; Le Zhang; Yan Zhang; Meng Zhang; Liping Liu; Jie Cao; Huaiqiang Hu; Wei Li; Cheng Liang; Liansheng Ma; Xuegang Meng; Linyu Tian; Changqing Wang; Lihua Wang; Yan Wang; Zhenhai Wang; Zhiqiang Wang; Zunchun Xie; Mingyao You; Jun Yuan; Chaosheng Zeng; Li Zeng; Lei Zhang; Xin Zhang; Yongwei Zhang; Bin Zhao; Saijun Zhou; Zhonghe Zhou

doi:10.3389/fneur.2023.1114204

The development of neurocritical care in China from the perspective of evaluation and treatment of critical neurological diseases

Front Neurol. 2023 Feb 21:14:1114204. doi: 10.3389/fneur.2023.1114204. eCollection 2023.

Authors

Yingying Su¹, Junfang Teng², Fei Tian¹, Jing Jing², Huijin Huang¹, Suyue Pan³, Wen Jiang⁴, Furong Wang⁵, Le Zhang⁶, Yan Zhang¹, Meng Zhang⁷, Liping Liu⁸, Jie Cao⁹, Huaiqiang Hu¹⁰, Wei Li⁷, Cheng Liang¹¹, Liansheng Ma¹², Xuegang Meng¹³, Linyu Tian¹⁴, Changqing Wang¹⁵, Lihua Wang¹⁶, Yan Wang¹⁷, Zhenhai Wang¹⁸, Zhiqiang Wang¹⁹, Zunchun Xie²⁰, Mingyao You²¹, Jun Yuan²², Chaosheng Zeng²³, Li Zeng²⁴, Lei Zhang²⁵, Xin Zhang²⁶, Yongwei Zhang²⁷, Bin Zhao²⁸, Saijun Zhou²⁹, Zhonghe Zhou³⁰

Affiliations

¹ Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
² Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
³ Department of Neurology, Nanfang Hospital of Southern Medical University, Guangzhou, China.
⁴ Department of Neurology, Xijing Hospital Fourth Military Medical University, Xi'an, China.
⁵ Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Department of Neurology, Xiangya Hospital, Central South University, Changsha, China.
⁷ Department of Neurology, Daping Hospital, The Army Military Medical University, Chongqing, China.
⁸ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁹ Department of Neurology, The First Hospital of Jilin University, Changchun, China.
¹⁰ Department of Neurology, The 960(th) Hospital of Joint Logistics Support, PLA, Jinan, China.
¹¹ Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou, China.
¹² Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, China.
¹³ Department of Neurology, The Xinjiang Uygur Autonomous Region People's Hospital, Urumqi, China.
¹⁴ Department of Neurology, West China Hospital, Sichuan University, Chengdu, China.
¹⁵ Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
¹⁶ Department of Neurology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China.
¹⁷ Department of Neurology, Tangshan People's Hospital of Hebei Province, Tangshan, China.
¹⁸ Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, China.
¹⁹ Department of Neurology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
²⁰ Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
²¹ Department of Neurology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
²² Department of Neurology, Inner Mongolia People's Hospital, Hohhot, China.
²³ Department of Neurology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
²⁴ Department of Neurology, The Affiliated Hospital of Guangxi Medical University, Nanning, China.
²⁵ Department of Neurology, The First People's Hospital of Yunnan Province, Kunming, China.
²⁶ Department of Neurology, Nanjing Drum Tower Hospital, Nanjing, China.
²⁷ Department of Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China.
²⁸ Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.
²⁹ Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
³⁰ Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China.

Abstract

Objective: To understand the varieties, evaluation, treatment, and prognosis of severe neurological diseases using the third NCU survey in China.

Design: A cross-sectional questionnaire study. The study was completed in three main steps: filling in the questionnaire, sorting out the survey data, and analyzing the survey data.

Results: Of 206 NCUs, 165 (80%) provided relatively complete information. It was estimated that 96,201 patients with severe neurological diseases were diagnosed and treated throughout the year, with an average fatality rate of 4.1%. The most prevalent severe neurological disease was cerebrovascular disease (55.2%). The most prevalent comorbidity was hypertension (56.7%). The most prevalent complication was hypoproteinemia (24.2%). The most common nosocomial infection was hospital-acquired pneumonia (10.6%). The GCS, APACHE II, EEG, and TCD were the most commonly used (62.4-95.2%). The implementation rate of the five nursing evaluation techniques reached 55.8-90.9%. Routinely raising the head of the bed by 30°, endotracheal intubation and central venous catheterization were the mostprevalent treatment strategies (97.6, 94.5, and 90.3%, respectively). Traditional tracheotomy, invasive mechanical ventilation and nasogastric tube feeding (75.8, 95.8, and 95.8%, respectively) were more common than percutaneous tracheotomy, non-invasive mechanical ventilation and nasogastric tube insertion (57.6, 57.6, and 66.7%, respectively). Body surface hypothermia brain protection technology was more commonly used than intravascular hypothermia technology (67.3 > 6.1%). The rates of minimally invasive hematoma removal and ventricular puncture were only 40.0 and 45.5%, respectively.

Conclusion: In addition to traditional recognized basic life assessment and support technology, it is necessary to the use of promote specialized technology for neurological diseases, according to the characteristics of critical neurological diseases.

Keywords: NCCU; critical neurological disease; evaluation; investigation; treatment.

Copyright © 2023 Su, Teng, Tian, Jing, Huang, Pan, Jiang, Wang, Zhang, Zhang, Zhang, Liu, Cao, Hu, Li, Liang, Ma, Meng, Tian, Wang, Wang, Wang, Wang, Wang, Xie, You, Yuan, Zeng, Zeng, Zhang, Zhang, Zhang, Zhao, Zhou and Zhou.