The pattern of medical admissions at the intensive care unit of the university of Port Harcourt teaching hospital, Nigeria

Abstract

Background. Intensive care units offer specialized care to critically ill patients and are an integral part of
modern health care. In low-income countries, with limited resources, the demand to optimize patient care and
improve outcomes depends on a better understanding of the pattern of medical referrals to the ICU for varying
reasons of resource allocation, staffing, and quality improvement initiatives. This study aims to describe and
provide valuable insights into the patterns of medical admissions to the intensive care unit (ICU), including
case mixes, intensive care interventions, duration of stay, and outcomes to highlight the need for proper
resource allocation
Methodology: A retrospective descriptive study was conducted at the University of Port Harcourt Teaching
Hospital ICU between January 2022 and December 2024. We reviewed all patients from the Department of
Internal Medicine referred to the ICU with a purely medical diagnosis. Data were retrieved from the ICU
admissions register and patients' medical records following ethical exemption approval.
Results: A total of 377 patients with medical referrals were reviewed, accounting for approximately 56.9% of
all ICU admissions. More males were admitted, and the mean age of patients was 48.6 ± 15.3 years. The
emergency unit was the commonest source of referral and offered a significant source of in hospital delays
prior to transfer to the ICU. The most common indication for ICU admission was stroke, with hemorrhagic
stroke, sepsis, and cardiogenic shock associated with the worst outcomes.
Conclusion: Stroke predominated medical referrals and provided the worst outcome. The in-hospital delays at
the emergency unit which became the largest source of referral contributed to the high mortality. This study
highlights the need to strengthen stroke care at the tertiary level of care as well as other medical referrals to
improve care.