Patterns Of Admission And Outcome Of Patients Admitted To Surgical Intensive Care Unit Of Jimma University Medical Center, Jimma, Southwest Ethiopia: A Five-Year Retrospective Study

Abstract

Background: The intensive care unit (ICU) is an area within a medical facility equipped with advanced technologies such as ventilators and personnel trained to provide intensive, advanced life-supportive care to critically ill patients. Although most intensive care units (ICUs) are found in high-income countries, they are increasingly a feature of health care systems in low- and middle-income countries. In resource-limited countries, the care is insufficient and mortality remains high for multiple reasons. Thus we sought to determine the admission pattern and outcome among patients admitted to surgical intensive care unit (SICU). Methods: A retrospective cross-sectional study was conducted by reviewing records of logbook and charts of patients admitted from January 1, 2018 to December 31, 2022. Epi data version 4.6 was used to enter the data. Data was then exported and analyzed through Statistical Package for the Social Sciences (SPSS) version 20. Both bivariate and multivariate logistic regression analyses were used to see the association between dependent and independent variable and a P-value < 0.05 was considered statistically significant. Results: A total of 1,384 patients were admitted to surgical intensive care unit (SICU) from January 1, 2018 - December 31, 2022. Eight hundred and ninety patients (64%) of all admissions had complete data. Out of 890 patients, 490 (55.1%) were males. Highest admission was observed from general surgery department accounting 349 (39.2%) regarding to their category of admission. The overall mortality rate was 36%. In multivariable analysis, mortality was associated with the need for mechanical ventilation (AOR: 6.01, P<0.001), urban residence (AOR: 2.64, P<0.001), inotropes (AOR: 9.73, P<0.001), muscle relaxant (AOR: 4.5, P=0.002) and abnormal mental status at admission (AOR: 3.402, P=0.005). Patients who stayed in ICU for less than four days were 2.16 times more likely to die than patients who stayed four or more days with (AOR=2.16, p<0.001). Conclusion: The overall mortality was considerably high and immediate post-operative and acute respiratory failure were the most common cause of admissions. Need for mechanical ventilator, Inotropes, muscle relaxant, urban residence, length of stay and level III of consciousness at admission were strongly associated with the clinical outcome of patients admitted to the surgical intensive care unit (SICU).