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Pattern of admissions to the University of Port Harcourt Teaching Hospital intensive care unit – a 10-year analysis
Abstract
Objective. To determine the admission pattern and outcome of patients in the Intensive Care Unit (ICU) of University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. Method. A retrospective review of all patients admitted to the ICU at the UPTH from 1996 to 2005 was carried out. Data were obtained from the ICU admission and discharge registers and nurses’ handover records.
Results. A total of 1 447 patients were admitted from 15 departments. There were 658 males and 789 females (male/female ratio 1:1.2). Ages ranged from 4 months to 90 years, the median age was 30 years and the mean age was 31.7±5.6 years. The highest proportion of admissions (48.7%) was from the Department of Obstetrics and Gynaecology, and the lowest from Ophthalmology and Anaesthesia (0.1%). Postoperative cases made up 62.1% of total admissions, with post-caesarean section (CS) contributing 65.7% of these. Non-availability of beds in the ward was the reason for the majority of the post-CS admissions. Up to 41.5% of the patients admitted to the ICU had no justifiable reason for admission. Average length of stay was 8.1±2.8 days, median 4.5 days. One patient was manually ventilated for 5 hours, none was mechanically ventilated, and none had invasive cardiac monitoring. Three children had peritoneal dialysis for acute renal failure. Unconscious patients were fed enterally through a nasogastric tube, while conscious patients ate orally. Analysis of outcomes showed that 597 patients (41.3%) were transferred to the wards, while 352 (24.3%) were discharged home. The outcome was not indicated in 128 cases (8.8%), 16 patients (1.1%) left the ICU against medical advice, 1 patient (0.1%) was referred to another tertiary institution and 1 (0.1%) absconded. Three hundred and fifty-two patients died, giving a mortality rate of 24.3%. Conclusion. The highest percentage of admissions to the ICU was from the Department of Obstetrics and Gynaecology. The majority of the patients did not require intensive care but were admitted because there was no bed in the wards.
