Intensive Care Unit admissions and outcome in a university teaching hospital: a 6-year review

Abstract

Background: Critically ill patients are a significant source of morbidity and mortality in hospitals. In resource-challenged economies like Nigeria, the number of deaths due to conditions requiring critical care is alarming. As in most other tertiary hospitals, critically ill patients are usually admitted into the Intensive Care Unit (ICU) of Nnamdi Azikiwe University Teaching Hospital (NAUTH).
Objectives: We sought to find out the pattern of admissions and the spectrum of disease conditions of patients and also, to assess the outcome of the cases admitted into the Intensive Care Unit (ICU).
Methodology: We undertook a six-year retrospective review of all admissions into the multi-disciplinary six-bed ICU of NAUTH Nnewi, August 2007 to July 2013. Data collected were analyzed using the Statistical Packages for the Social Sciences (SPSS) version 24.0, and presented in relevant charts and tables.
Results: During the period, the total number of hospital admissions was 36,386, out of which there were 933 (3%) ICU admissions but, only 521 (56%) case notes were available for analysis. There were 346 males and 175 females with a male:female ratio of 2:1. Trauma admissions were mostly emergencies 42.7%, with a mean ICU length of stay of 37.6days. Survivors had a statistically significant longer length of stay (LOS) 103.8 days than non-survivors 51.7days (p = 0.0001). Mortality rate of trauma patients was 9.7%, and road traffic accidents were responsible for most deaths 32.2%.
Conclusion: Intensive care admissions cover a broad spectrum of diseases and specialties. Trauma, especially, due to road traffic accidents and burns, is a very important cause of morbidity and mortality in ICU. Management strategies should include early admission and active life support measures. There is need to improve trauma and hospital care of these patients in order to improve their outcome.