General surgical admissions in the intensive care unit in Ibadan, Nigeria: a 30 month review
AbstractObjectives:The Intensive Care Unit (ICU) has improved patient outcome in complex surgeries while the costs of maintaining services are high. ICU services in developing countries are often inadequate due to lack of funds. This study reviews the pattern and outcomes of General Surgical patients admitted to the ICU of our hospital.
Design: This is a retrospective study.
Setting: All general surgical patients admitted into the ICU of the University College Hospital, Ibadan from January 2010 to June 2012. The demographic data, diagnosis, indication for ICU admission, intervention(s) in the ICU and outcomes were obtained from the patients' records.
Subjects: General surgical patients admitted to the intensive care unit.
Main Outcome Measures: Two hundred and twenty three (223) patients were admitted in the ICU.
Results: There was a male: female ratio of 1:1.7. This constituted 15.4% of the ICU admissions. 78.9 %( 176) of the records were retrieved. 93 patients (52.8%) and 83 (47.2%) were emergency and elective cases respectively. Age ranged between 16-88 years with a mean (SD) of 37.9 (16.8). Peritonitis 76 (43.2%) was the commonest clinical diagnosis. The mean duration of admission was 3.1 (3) days. 157 patients (89.2%) were discharged to the wards while 19 patients (10.8%) died in the ICU. Significant predictors of mortality were oliguria and use of Vaso-active support.
Conclusion: Ninety percent (90%) of ICU deaths in general surgery occur in risk emergency surgical patient. Secondly there is a need for a High Dependency Unit (HDU) to serve as a buffer/filter for patients that require only close monitoring.