Neurocritical Care Services in Australia: A Nation-Wide Survey
Abstract number :
V.100
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2021
Submission ID :
1825808
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:50 AM
Authors :
Xiuxian Pham, MBBS (Hons), BMedSci (Hons) - 1. Monash University, 2. Alfred Health; David Pilcher, MBBS MRCP FRACP FCICM - Australian and New Zealand Intensive Care Society (ANZICS); Edward Litton, MBChB, FCICM, MSc, PhD - Australian and New Zealand Intensive Care Society (ANZICS); Patrick Kwan, BMedSci (Hons), MB BChir, PhD, FRACP - Director of Epilepsy, Department of Neurology, Alfred Health; Piero Perucca, MD, PhD, FRACP - Director of Epilepsy, Comprehensive Epilepsy Program, Austin Health; Andrew Udy, BHB, MB ChB, PGCert(AME), PhD, FCICM - Deputy Director, Australian and New Zealand Intensive Race - Research Centre, Monash University
Rationale: Neurocritical care (NCC) is a rapidly developing field within intensive care medicine. However, NCC implementation is variable worldwide and remains an evolving area in Australia. This study aimed to survey intensive care units (ICUs) in Australia to determine the availability of NCC services.
Methods: An electronic questionnaire was distributed via the Australian and New Zealand Intensive Care Society (ANZICS), between August and October 2020, with each ICU in Australia invited to participate. Survey questions included admission characteristics, availability and access to NCC services, and use of neuromonitoring devices. De-identified data were analysed using descriptive statistics. The Alfred Hospital HREC provided ethics approval (Ref 289/20).
Results: Seventy-eight of 175 (44.6%) ICUs participated in the survey. 34.6% (27/78) of ICUs did not routinely treat acute brain injured patients. Of those that did (n=51), only 4 centres reported specialising in NCC, while 9 employed an intensivist subspecialising in NCC. A neurosurgical unit was present in 44.9% (35/78) of hospitals. 35.9% (28/78) of hospitals did not have a neurology unit, and 15.4% (12/78) had access to a consulting service only. 76.9% (60/78) did not have access to a dedicated epilepsy service. Of the ICUs that routinely treated brain injuries, intermittent electroencephalography, ICP monitoring and extra-ventricular CSF drainage were used in 82.4% (42/51), 76.5% (39/51), and 76.5% (39/51), respectively. Brain tissue oxygen monitors and optic nerve sheath diameter assessment were only used in 2% (1/51).
Conclusions: Although two-thirds of ICUs providing survey data treated acute brain injured patients, access to specialised neurocritical care, neurosurgical and/or neurology services was highly variable. Moreover, utilisation of advanced neuromonitoring devices was limited. Further evaluation is necessary to identify if patient outcomes improve in centres with greater access to neurocritical care services.
Funding: Please list any funding that was received in support of this abstract.: Nil.
Health Services (Delivery of Care, Access to Care, Health Care Models)