Patterns of Admission and Clinical Outcomes Among Patients Admitted to Medical Intensive Care Unit of a Teaching and Referral Hospital, Northwest Ethiopia

Abstract

Background The intensive care unit (ICU) is a health care delivery service for patients who are in critical condition with potentially recoverable diseases. Patients can benefit from more detailed observation, monitoring and advanced treatment than other wards or department. The care is advancing but in resource-limited settings, it is lagging far behind and mortality is still higher due to various reasons. Therefore, we aimed to determine the admission patterns, clinical outcomes and associated factors among patients admitted medical intensive care unit (MICU). Methods A retrospective cross-sectional study was conducted based on a record review of logbook and charts of patients admitted from September, 2015 to April, 2019. Data were entered and analysed using SPSS version 20. Both bivariate and multivariate logistic regression analyses were used and a P-value < 0.05 was considered statistically significant. Results A total of 738 patients were admitted to medical intensive care unit (MICU) during September, 2015 - April, 2019. Five hundred and four patients (68%) of all intensive care unit (ICU) admissions had complete data. Out of the 504 patients, 268 (53.2%) patients were females. Cardiovascular disease 182(36.1%) was the commonest categorical admission diagnosis. The overall mortality rate was 38.7%. In the multivariate analysis, mortality was associated with need for mechanical ventilation (AOR = 5.87, 95% CI: 3.24 - 10.65) and abnormal mental status at admission (AOR = 2.8, 95% CI: 1.83-4.29). Patients who had stay less than four days in MICU were 5 times more likely to die than those who has stay longer time (AOR= 5.58, 95% CI: 3.58- 8.69). Conclusions The overall mortality was considerably high and cardiovascular diseases were the most common cause of admission in MICU. Need for mechanical ventilator, length of intensive care unit stay and mental status at admission were strongly associated with clinical outcome of patients admitted to medical intensive care unit.

Admission and Mortality Patterns in Intensive Care Delivery at Enugu State University of Science and Technology Teaching Hospital: A Three-Year Retrospective Study

“…In general, the proportion of mortality increased with increasing age, with the highest level of mortality seen among patients aged 80-99 years old (75%) and the lowest among patients aged 0-19 years old (16.7%). This agrees with the reports of a study carried out in Ethiopia, which reported the highest rate of mortality among patients more than 60 years old [ 18 ]. However, it opposes a previous study that found no association between old age and increased mortality [ 3 ].…”

“…This finding is comparable to results from other parts of Nigeria, which reported ICU mortality rates of 34.6% and 40.8% in Calabar and Abakaliki, respectively [ 3 , 17 ]. Other African countries reported ICU mortality rates ranging from 38.7% to 40.1% [ 14 , 18 , 19 ]. However, these are comparatively higher than the findings in more developed nations including the Scandinavian countries (Finland, Norway, and Sweden) (9.1%) and the United States of America (11.3%) [ 9 , 20 ].…”

Factors Associated with ICU Mortality at Hawassa University Comprehensive Specialized Hospital (HUCSH)

“…The overall mortality rate of the ICU was 45.8 %. This is in congruent with studies reported from Ethiopia and Nigeria ( 2 – 6 ).…”

“…In the present review, the median age was in the third decades with proportional male to female ratio and median ICU admission was three days. These results were consistent with prior reports from other referral hospitals in Ethiopia ( 1 , 2 ). The overall mortality rate of the ICU was 45.8 %.…”

“…ICUs in most of the developed world are high-technology facilities with the most advanced medical technology and skilled personnel. Caring for the critically ill patients is a challenge in developing countries, where health needs often outstrip available resources ( 2 , 3 ). Globally, non-communicable diseases are the leading cause of intensive care unit Death, and the burden of disease are rising fastest among lower-income countries.…”