Intensive Care Unit Admissions in Federal Medical Centre Umuahia South East Nigeria

Abstract

Background: The Federal Medical Centre Umuahia(FMCU) is a tertiary referral centre in Abia state, southeast Nigeria serving a catchment area made of Abia state and environs . An intensive care unit(ICU) was established in the hospital in December 2009 to improve healthcare delivery to critically ill patients.
Objective: To determine the admission patterns and report the initial experience in the intensive care of patients in the FMCU.
Methods: This is a retrospective study of the patients admitted into the ICU of FMCU from December 2009 to March 2011.Data retrieved from the patients ICU records included demographics, indication for admission, length of stay in ICU, and outcome of stay. The cost of ICU care was extracted from the financial records of the patient following discharge or demise. Data acquisition and analysis was performed using the statistical package for social sciences(SPSS) version 15.
Results: A total of 87 patients were studied consisting of 59 males and 28 females. The ages ranged from 2days to 87years with a mean age of 41±2.34 years. There were 11 patients within the pediatric age range(12.6%). Post-operative surgical patients(51) accounted for the majority of the admissions (58.6%).There were also 21 non-operated trauma cases(24.1%), 7 medical cases (8.1%), 8 obstetrics and gynecological cases(9.2%). Post-operative admissions were mainly emergencies --39 cases(76.5%) cases while 12(23.5%) were elective. Most post-operative ICU admissions followed abdominal surgery -31 cases(58.8%) while neurological trauma accounted for most non-operated trauma 17cases (81%).The cost of stay per patient ranged from N2745.65 to N238123.4 ($82.23 to $1536.28) with an average cost per day of N19506.75($125.85). The cost per day for mortality cases was N28598.74($184.51) . The modal length of ICU stay was 2days with a mean of 3.63±0.34days and a range of one to sixteen days. About 68.4% of the patients spent =3days(38.3% of total ICU days),while 31.6% spent >3days(61.7% of total ICU days).Of the 87 patients,57 (65.5%)were discharged from ICU to the wards,28(32.2%) died in ICU while 2(2.3%) were referred to bigger centers. Twelve mortalities(42.8%) were among the emergency postoperative patients and 10(35.8%) non-operated trauma patients(80% of which are neurological trauma).
Conclusion: From our study, most ICU admissions come from the operating theatre. The mortality is high and is comparable to other studies in Africa. The cost of stay is very high when compared with annual per capita income in Nigeria of $1190.

Keywords: Intensive care unit, admissions, outcome