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Early experience of a dedicated heart–brain integrated ward at Peking Union Medical College Hospital: a retrospective descriptive study

Year: 2026

Type: article

Abstract: BACKGROUND: Heart-brain comorbidities present unique diagnostic and therapeutic challenges because neurological and cardiac conditions often share pathophysiological mechanisms yet create conflicting treatment demands. Multidisciplinary wards integrating neurosurgery, cardiac surgery, cardiology, and neurology have been proposed, but real-world experience remains limited. We report the initial experience of a dedicated heart-brain integrated ward at a Chinese tertiary referral center. METHODS: We conducted a retrospective descriptive study of all consecutive patients admitted to the Heart-Brain Integrated Ward at Peking Union Medical College Hospital between July 1 and August 21, 2026. Clinical data were entered prospectively into the electronic medical record during routine care and analyzed retrospectively. Variables included demographics, neurological and cardiac diagnoses, a six-category comorbidity classification, MDT decisions, treatment strategies, and discharge outcomes. Treatment categories were predefined as: (i) diagnostic procedures, (ii) therapeutic single-system interventions, (iii) staged dual-system treatment within the same admission, and (iv) synchronous dual-system treatment in a single session. RESULTS: Fifty-six patients (42 males, 75.0%; mean age 62.4 ± 12.2 years, range 19-80) were enrolled. The most common category was I.1 (shared atherosclerotic vascular disease; 29/56, 51.8%), predominantly ischemic cerebrovascular disease with coronary artery disease (18/56, 32.1%). Category IV (psychocardiological disorders) accounted for 12 patients (21.4%), and Category V (therapeutically interactive) for 3 (5.4%). All patients underwent at least one MDT discussion (100%), and 55 (98.2%) required a second. Of 56 patients, 41 (73.2%) underwent surgical or endovascular intervention and 15 (26.8%) received medical management or remained under evaluation. Among treated patients, 4 (7.1%) received synchronous dual-system procedures, 13 (23.2%) completed staged procedures within the same admission, and 24 (42.9%) underwent single-system intervention. Fourteen patients (25.0%) required intervention for both organ systems. No in-hospital mortality or major procedure-related complications were observed among 38 discharged patients (67.9%); 18 patients (32.1%) remained hospitalized at data cutoff. CONCLUSIONS: Establishing a dedicated heart-brain integrated ward at a tertiary referral center appears operationally feasible and enables structured MDT-based care for complex neuro-cardiac patients. The early disease spectrum is dominated by atherosclerotic pan-vascular disease. Synchronous dual-system procedures were performed in a small selected subset without observed major early events among discharged patients, but this cannot establish safety or generalizability. Larger prospective studies with controlled comparisons and longer follow-up are needed.

Source: Chinese Neurosurgical Journal

DOI: 10.1186/s41016-026-00451-9