Evaluation and impact of the ABCDEF bundle in a neurocritical patient population: a prospective observational study.

Authors

Vanessa Campozano, Presley Gruezo-Realpe, Israel Rosero-Basurto, Xavier Grandes, Luis Montalvo Alvarado, Francisco Mercado Villamar, Carola Giménez-Esparza, Daniel Agustín Godoy

Published in

Medicina intensiva. Pages 502561. Sep 22, 2026. Epub Sep 22, 2026.

Abstract

To evaluate the clinical impact of adherence to the ABCDEF bundle in neurocritical patients admitted to an Intensive Care Unit (ICU) in Ecuador.
A retrospective, observational, single-center study conducted between 2022 and 2024.
The ICU of a tertiary-level hospital in Guayaquil, Ecuador.
Sixty adult neurocritical patients with ICU stays longer than 48 h were included. Patients were classified into two groups according to their adherence to the ABCDEF bundle: high adherence (≥4 components) and low adherence (≤3 components).
Implementation of the ABCDEF bundle, including pain assessment, individualized sedation, delirium screening, early mobilization, and family participation. The main outcome measures were ICU mortality, duration of mechanical ventilation (MV), ICU length of stay, and incidence of delirium.
High adherence was associated with a shorter MV duration (median 11 [IQR 7-15.8] vs. 15 [15-18] days; p = 0.001) and shorter ICU stay (15 [10-20] vs. 20 [18-21.8] days; p =  0.016). Mortality was lower in the high-adherence group (23.3% vs. 46.7%), although this difference was not statistically significant in the bivariate analysis (p = 0.104). In the multivariate analysis, low adherence was independently associated with higher mortality (OR: 4.51; 95%CI: 1.07-19.05; p = 0.040). The incidence of delirium was higher in the high-adherence group (53.3% vs. 0%; p < 0.001), a finding that requires further investigation to clarify its clinical significance.
Adherence to the ABCDEF bundle was associated with improved clinical outcomes in neurocritical patients, supporting its implementation in ICUs with limited resources.

PMID:
42773054
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.

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