This large-scale retrospective cohort study analyzed the clinical and epidemiological profiles of over 62,000 Intensive Care Unit (ICU) patients across seven hospitals, finding that the 10,884 patients admitted for primary neurological diagnoses differed significantly from non-neurological patients.

Those with neurocritical conditions were typically older and had a lower initial level of consciousness, yet they presented with lower APACHE II and SOFA scores, shorter ICU stays, and, notably, lower overall mortality rates than the general ICU population.

However, despite the lower mortality, surviving patients admitted for neurological reasons experienced significantly greater long-term functional limitations (Modified Rankin Scale scores of 4–6).

The leading causes of neurological admission were postoperative monitoring for intracranial surgery (32.6%), ischemic stroke (19%), and traumatic brain injury (17%).

Cox regression analysis identified several independent factors associated with an increased risk of death and unfavorable outcomes in neurocritical patients.

These high-risk factors included older age, the use of vasoactive drugs upon admission, elevated creatinine levels, a lower level of consciousness in the first 24 hours, and specific diagnoses such as ischemic stroke, hemorrhagic stroke, and subarachnoid hemorrhage.

This highlights the dual challenge in neurocritical care: while more patients survive, specific clinical markers and admission diagnoses predict a greater hazard for poor functional recovery.

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