Retrospective review of profile of intensive care unit admissions and outcomes in a tertiary care hospital of Himalayan region

Abstract

Background: An Intensive care unit (ICU) is an area where highest level of care is given with close invasive and non-invasive monitoring to a critically ill patient. Medical audit is must to assess the quality care provided and lay down policies for future. Objectives: To review retrospectively the profile of patients admitted to ICU and assess their outcome.Methods: From January 2016 to December 2016, ICU records of all admissions, referred, discharges, and deaths were utilized for the purpose of this study. Data extracted from the records included age, sex, diagnosis and outcome.Results: A total of 2316 patients were admitted to ICU. Males were 1489 (64.3%) and females were 827 (35.7%). Most of the patients (42.8%) were between 46-70 years. Most of the patients were shifted from emergency (48.5%) and it was associated with better outcome. A total of 49.6% patients were shifted out of ICU in stable condition while mortality was 28.6%. Around 21.8% patients left ICU against Medical advice.Conclusions: Majority patients admitted to ICU were of general medicine and neurosurgery. Survival was inversely related to age. Mortality was not associated with sex. Outcome was also related to the source from where patient was admitted.

A Prospective Study on the Outcome of Semi-Closed Neurointensive Care in A Tertiary Care Hospital Located in A Rural Area of Eastern Nepal: A Lower-Income Developing Country

“…The incidence of neurological disease that required ICU admission in our study was 27.2% while in the other studies it varied from 30-40%. [10][11][12][13][14] The lower incidence in our study may be due to geographical variation and people from all communities may not afford a private hospital for treatment.…”

“…Mortality in the intubated patients was 19% while in other studies varied from 25 to 40%. [10][11][12][13][14][19][20][21] This difference may be due to the co-management of patients by neurointensivist in our study.…”

“…The readmission rate in our study was 1.25% and 50% patient recovered and was transferred to ward while in other studies readmission was 10-12%. [10][11][12][13][14] Mortality in neurosurgical patients was 6.4% while in other studies it varied from 10.5-40%. 11,[19][20][21] In present study, LAMA in neurosurgical patients was 1.4% while in a study by Acharya et al 21 it was 7.03%.…”

“…Male (71.7%) was more common than females (28.2%) in this study which is similar to other studies. [10][11][12][13][14][19][20][21] The limitations of our study are primarily related to small sample size. Glasgow outcome scale was not recorded so long term of a patient was not known.…”

“…Neurological patients account for 30-40% [10][11][12][13][14] of total admissions in the ICU. Studies have shown that neurological patient managed by neurointensivist in a closed ICU has a better outcome.…”