Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1

The PRINCE Study Investigators

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
JournalNeurocritical care
DOIs
StateAccepted/In press - Jan 1 2019

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Oceania
North America
Organizations
Middle East
Latin America
Intensive Care Units
Resource Allocation
Nervous System Diseases
Pharmacists
Critical Illness
Nursing

Keywords

  • Critical care
  • Neurocritical care
  • Observational study
  • Outcomes
  • Prospective

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Worldwide Organization of Neurocritical Care : Results from the PRINCE Study Part 1. / The PRINCE Study Investigators.

In: Neurocritical care, 01.01.2019.

Research output: Contribution to journalArticle

@article{11823cefeea941508884ee7c0a662adf,
title = "Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1",
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.",
keywords = "Critical care, Neurocritical care, Observational study, Outcomes, Prospective",
author = "{The PRINCE Study Investigators} and Suarez, {Jose I.} and Martin, {Renee H.} and Colleen Bauza and Alexandros Georgiadis and {Venkatasubba Rao}, {Chethan P.} and Eusebia Calvillo and Hemphill, {J. Claude} and Gene Sung and Mauro Oddo and Taccone, {Fabio Silvio} and LeRoux, {Peter D.} and Layon, {A. J.} and Aarti Sarwal and Abbas Ali and Abhijit Lele and Jarquin-Valdivia, {Adrian A.} and Agnieszka Misiewska-Kaczur and Ahmad Ahmad and Deeb, {Ahmad M.} and Jabbary, {Ahmed Al} and Ahmed Fathy and Alexander Chan and Alexander Kern and Alexey Gritsan and Bshabshe, {Ali Al} and Ali Malek and Alois Schiefecker and Neto, {Alvaro Reao} and Ameer Hassan and Zahrani, {Amer Rashed Al} and Sukumaran, {Anakara V.} and Sarma, {Anand K.} and Anders Aneman and Andreas Kramer and Andrew Naidech and {Lacerda Gallardo}, {Angel J.} and Angela Miller and Anne O’Connor and Anthony Kim and Arash Afshinnik and Ari Katila and Audrey Paulson and Augusto Parra and Axel Rosengart and Ayesha Almemari and Baltasar Sanchez and Banambar Ray and Barbara McCrum and Jennifer Berkeley and Marek Mirski",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s12028-019-00750-3",
language = "English (US)",
journal = "Neurocritical Care",
issn = "1541-6933",
publisher = "Humana Press",

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TY - JOUR

T1 - Worldwide Organization of Neurocritical Care

T2 - Results from the PRINCE Study Part 1

AU - The PRINCE Study Investigators

AU - Suarez, Jose I.

AU - Martin, Renee H.

AU - Bauza, Colleen

AU - Georgiadis, Alexandros

AU - Venkatasubba Rao, Chethan P.

AU - Calvillo, Eusebia

AU - Hemphill, J. Claude

AU - Sung, Gene

AU - Oddo, Mauro

AU - Taccone, Fabio Silvio

AU - LeRoux, Peter D.

AU - Layon, A. J.

AU - Sarwal, Aarti

AU - Ali, Abbas

AU - Lele, Abhijit

AU - Jarquin-Valdivia, Adrian A.

AU - Misiewska-Kaczur, Agnieszka

AU - Ahmad, Ahmad

AU - Deeb, Ahmad M.

AU - Jabbary, Ahmed Al

AU - Fathy, Ahmed

AU - Chan, Alexander

AU - Kern, Alexander

AU - Gritsan, Alexey

AU - Bshabshe, Ali Al

AU - Malek, Ali

AU - Schiefecker, Alois

AU - Neto, Alvaro Reao

AU - Hassan, Ameer

AU - Zahrani, Amer Rashed Al

AU - Sukumaran, Anakara V.

AU - Sarma, Anand K.

AU - Aneman, Anders

AU - Kramer, Andreas

AU - Naidech, Andrew

AU - Lacerda Gallardo, Angel J.

AU - Miller, Angela

AU - O’Connor, Anne

AU - Kim, Anthony

AU - Afshinnik, Arash

AU - Katila, Ari

AU - Paulson, Audrey

AU - Parra, Augusto

AU - Rosengart, Axel

AU - Almemari, Ayesha

AU - Sanchez, Baltasar

AU - Ray, Banambar

AU - McCrum, Barbara

AU - Berkeley, Jennifer

AU - Mirski, Marek

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - Critical care

KW - Neurocritical care

KW - Observational study

KW - Outcomes

KW - Prospective

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