Trends and patterns of ICU referrals in the Kingdom of Saudi Arabia during the COVID- 19 pandemic: Results from the National Saudi Medical Appointments and Referrals Centre

Abstract

Background ICU e-referrals are an important indicator for exploring potential deficiency in critical care resources. This study explores the epidemiology and patterns of ICU referrals across all regions of the Kingdom of Saudi Arabia (KSA) during the COVID-19 pandemic using routinely collected secondary data between April 2020 and December 2021. Methods This descriptive epidemiological study used data from the Saudi Medical Appointments and Referrals Centre (SMARC). The analysed variables included age, sex, month and year of referral, the reason and the speciality and region from which the referral had originated. Descriptive statistics were performed as well as mapping of administrative areas according to the rate of referral requests per 10,000 of the population. Results During the study period, 36,619 patients had an ICU e-referral request. The average age of these patients was 54.28 ± 20.46 years. Males constituted 64.81% of all requests. Referrals due to being out of scope made up 71.44% of requests. Referrals related to medical specialities were the most common followed by surgical ones (62.48% and 22.13%). The temporal pattern of ICU requests shows a peak in Jully and August of 2020 and a second peak during May of 2021. The graphical distribution of requests shows that these were highest for the Northern Border and Albaha administrative areas. Conclusions The temporal patten and geographic distribution of ICU referrals identified in this study have been found to mirror that of previously reported critical cases in the KSA. The implementation of preventive measures and the introduction of the vaccination programs have been found to positively affect ICU referral requests. Also, adjustment for population size should be taken into consideration in healthcare resource management and policy.