ADMISSION PATTERNS AND OUTCOMES IN THE MEDICAL INTENSIVE CARE UNIT OF ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA.
Background: Knowledge of the characteristics and outcomes of critically ill patients admitted to Medical Intensive Care Unit (MICU) helps with identification of priorities and the resources required to improve care. The objective of this study was to examine admission patterns and outcomes in MICU at St. Paul’s Hospital Millennium Medical College.
Materials: A retrospective review of 1256 patients’ case notes who were admitted to the MICU at St. Paul’s Hospital Millennium Medical College from 2007 to 2012 was carried out. The data was analyzed by SPSS version 18.0 to obtain descriptive and inferential measurements. P values < 0.05 were considered significant for all tests.
Results: Among specific diagnoses, diabetic ketoacidosis; 187 (14.9%), was the leading cause of admission, followed by all Strokes; 103 (8.2%), and Unspecified Diseases of Circulatory System; 81 (6.4%). The overall mortality rate was 39 %. Strokes were the leading causes of death, accounting for 12.2% of total deaths. The deceased were older than the survivors by five mean age years, mean age (±SD) 41.9 (± 18.5) and 36.7 (± 17.4) years, respectively.
Conclusions: Non- communicable will continue to be increasing proportion of ICU admissions in the study. The mortality in this study is also substantial, and reasons looks like late admissions and limited care in the facility. Improving the ICU infrastructure and staffing with skilled personnel might improve the quality of care.
Adudu OP, Adudu OG. Working practices and patient outcome in the intensive care unit of the University of Benin Teaching Hospital. JMBR: A Peer-review Journal of Biomedical SciencesJune 2004; Vol. 3 No. 1: 67–72.
Johannes L, Cees S, Bert L, Betto D, Jan HB G ,Jan H Z. Discomfort and factual recollection in intensive care unit patients. Critical CareDecember 2004; 8 (6).
Jlin F, CP Wickramaratne, RSB Dissanayake, SH Kolambage, MAU Aminda. Studying current status of intensive care services in Sri Lanka. Int J Crit Illn Inj Sci. 2012 Jan-Apr; 2(1): 11–16.
Sonia F; Dominik E, Regula M, Zuercher Z. Medical futility: Predicting outcome of intensive care unit patients by nurses and doctors—A prospective comparative study. Crit Care Med 2003; 31(2).
Paul M. Should Age Limit Admission to the Intensive Care Unit? AM J HOSP PALLIAT CARE 2007; 24: 63.
Arthur K, Martin D, Jane N. National intensive care unit bed capacity and MICUpatient characteristics in a low income country. BMC Research Notes 2012; 5:475.
Guidelines for intensive care unit admission, discharge, and triage. Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med. 1999; 27:633-638.
Amsel M,Mathewos A. The changing pattern of diseases in the Mid 1990's: experience of a teaching Hospital in North Western Ethiopia. Ethiop. J. Health Dev. 1999; 13(1):1-7.
Zenebe M, Mengistu A, Kebede O, Getachew T. Pattern of Admissions to the Medical Intensive Care Unit of Addis Ababa University Teaching Hospital , Ethiop Med J 2006;44(1).
Phillipo L, Japhet G, Ramesh D, et al.Trauma admissions to the Intensive care unit at a reference Hospitalin Northwestern Tanzania. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2011; 19:61
Roger C. B, Newell E. M, David H. E, Eric H. Analysis of Indications for Intensive Care Unit Admission. Chest 1993; 104:1806-11
Lisha J, Pandmini D, jenny J, Shoba G. Drug utilization study of antimicrobial agents in medical intensive care unit of a tertiary care Hospital. Asian Journal of Pharmaceutical and Clinical Research, 2011; 4(2)
Yaseen A, Venkatesh S, Samir H, Abdillah S, Salim M. A prospective study of prolonged stay in the intensive care unit: Predictors and impact on resource utilization. International Journal for quality in Health care 2002;14(5):403-410.
Mato C, Onwuchekwa A, Aggo A. Pattern of admissions to the University of Port Harcourt Teaching Hospital intensive care unit – a 10-year analysis. SAJCC July 2009; 25(1).
FMOH. HMIS Disease Classification. Tulane University Technical Assistance Program, Addis Ababa, Ethiopia. June, 2008.
Critical Care Safety: Essentials for MICUPatient Care and Technology. ECRI Institute, 2007.
Brian H C, Siân R, David J, Graeme M, Luke V. Quality of life in the five years after intensive care: a cohort study. Critical Care 2010; 14:R6.
Towards an ethical management of intensive care: Assessment of adequacy of MICUadmission. Minerva Anestesiol 2002; 68:201-7.
José H, Peter S, Henk V, Augustinus S, Jan B.Quality of life before intensive care unit admission is a predictor of survival. Critical Care 2007;11(4).
Neill A, Robert F, Satish B, Gordon R. Critical Care 1. Critical care and the global burden of critical illness in adults. Lancet 2010; 375: 1339–46.
Nigatu E, Solomon G, Berhanu K. Nosocomial bacterial infections in a tertiary Hospital in Ethiopia. Infection Prevention : January 2011; 12(1)
Steffen C, Reimar W T, Martin B J, et al. Preadmission statin use and one-year mortality among patients in intensive care - A cohort study. Critical Care 2010; 14:R29.
Faponle AF, Adenekan AT. Obstetric Admissions into the Intensive Care Unit in a Sub-urban University Teaching Hospital . NJOG 2011 ; Nov-Dec; 6 (2): 33-36.
Saulius V, Jurate S, Juozas I. Determinants of outcome in elderly patients admitted to the intensive care unit. Age and Ageing 2005; 34: 157–162.
ViktoriaD.,Martin W., VeronikaG., StefanJ., GünterL., HannoU., BarbaraE., Jukka Takala and Walter R. Causes of death and determinants of outcome in critically ill patients. Journal of critical care 2006 10(6).
Hendry R Sawe, Juma A Mfinanga, Salum J Lidenge, Boniventura CT Mpondo, Silas Msangi, Edwin Lugazia, Victor Mwafongo, Michael S Runyon, and Teri A Reynolds Disease patterns and clinical outcomes of patients admitted in intensive care units of tertiary referral hospitals of Tanzania. BMC Int Health Hum Rights. 2014; 14: 26.
Philip R. Lee Institute for Health Policy Studies. http://healthpolicy.ucsf.edu/content/icu-outcomes. University of California, San Francisco. Accessed on December 22, 2014.