To define the epidemiology of critical illness and characterize drivers of clinical deterioration among neurology inpatients in a resource-limited hospital in Zambia.

We conducted a prospective, longitudinal, registry-based study of all inpatients admitted to the UTH neurology service. We followed patients throughout their admissions and extracted multiple clinical data points from their medical records including admission diagnosis, diagnostic test results, treatments administered, location of care (ward vs ICU), discharge functional status, cause of death (when applicable), and presence/absence of pre-defined markers of clinical deterioration warranting ICU-level care (mental status decline, recurrent seizures, hemodynamic instability, to name a few). We present a preliminary descriptive analysis of an ongoing study.

Of 500 admissions enrolled between Jan-Sep 2023, 48% of admissions were for stroke (56% ischemic, 35% hemorrhagic, 9% of unknown type), 18% for seizure (of whom 20% had status epilepticus), and 7% for neurologic infections. The two leading causes of death were sepsis (35% of inpatient deaths) and aspiration pneumonia (22%). The overall inpatient mortality rate was 24%, with only 15% of patients receiving care in an ICU.