KUMJ | VOL. 24 | NO. 3 | ISSUE 96 | JULY-SEPTEMBER, 2026

Spectrum of Critically Ill Neurological and Neurosurgical Patients Admitted to a Level 3 Intensive Care Unit in Nepal: Analysis by Diagnosis, Clinical Profile, and Outcome
Khanal K, Poudel S, Shrestha P, Shrestha A, Shrestha A, Shakya S, Aryal S, Ghimire A, Neopane A

Abstract:
Background Neurocritical conditions significantly contribute to disease burden in low-income and middle-income countries (LMICs) like Nepal, where epidemiology and outcomes data are limited. This study analyzes the spectrum of neurocritical patients admitted to a level 3 intensive care unit (ICU) in Nepal, focusing particularly on diagnosis, age distribution, and clinical outcomes. Objective To describe the demographic and clinical profile of patients and determine the factors associated with outcomes in the neuro-intensive care unit. Method A retrospective, single-center, observational study was conducted over three years (January 2021 to December 2023) in the Neuro-intensive care unit of Nepal Mediciti Hospital. Patients were categorized based on their primary diagnosis. Data from 820 patients were analyzed using descriptive statistics for demographics, diagnoses, duration of intensive care unit stay, mechanical ventilation, and outcomes (survival, mortality, survival, mortality, and leave against medical advice withdrawal of treatment). Data were extracted using the National Intensive Care Unit Registry maintained by NICRF (Nepal Intensive Care Research Foundation). Result A total of 820 cases were analyzed. Males constituted 65.9% of admissions. The most preponderant patient population was aged ≥ 61 years, with cerebrovascular diseases (47.2%), being the leading diagnosis, followed by trauma (19.8%). Mechanical ventilation was required in 32.8% of cases. Overall ICU survival was 71.3%, with 28.7% mortality. Older age, lower admission Glasgow Coma Scale, vascular diagnosis, and mechanical ventilation were independent predictors of ICU mortality. Conclusion Cerebrovascular diseases and trauma are the primary drivers of Neuro-intensive care unit admissions. Prioritizing stroke prevention and trauma reduction programs may reduce mortality in neurocritical care.
Keyword : Intensive care unit, Mortality, Neurocritical care, Outcome