scholarly journals Surgical Admissions and Treatment Outcomes at a Tertiary Hospital Intensive Care Unit in Ethiopia: A Two-Year Review

2020 ◽  
Vol 30 (5) ◽  
Author(s):  
Kirubel Abebe ◽  
Tesfaye Negasa ◽  
Fitsum Argaw
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Treatment Outcomes ◽  
Ventilatory Support ◽  
Tertiary Hospital ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Medical College ◽  
Generalized Peritonitis

BACKGROUND፡ Intensive Care Unit (ICU) is a special unit where critically ill patients who require advanced respiratory or hemodynamic support are admitted. Little has been published about surgical intensive care unit patients in Ethiopia. The aim of this study was to assess the pattern of admission and treatment outcomes of adult surgical patients admitted to the Intensive Care Unit at St. Paul’s Hospital Millennium Medical College (SPHMMC).METHODS: A two-year retrospective medical record review of all adult surgical patients admitted to Intensive Care Unit at St. Paul’s Hospital Millennium Medical College .RESULTS: Surgical patients made up 91(22.1%) of 411 admissions of adult intensive care unit.Of these, 82 (M: F = 1.5:1) patients were analyzed. Age ranged from 16 to 82 years with a mean age of 43 years (SD +/-18.2). Emergency admissions accounted for 70(85.4%) cases. The top three primary admission diagnoses were generalized peritonitis secondary to perforated viscus (25,30.5%), bowel obstruction (21,25.6 %) and trauma (13,15.9%). Acute respiratory failure (38,46.3%) and septic shock (23,28.0%) were the leading indications of intensive care unitadmission. Most patients (62,75.6%) received mechanical ventilatory support.The mean length of intensive care unit stay was 7.3 days (SD+/-5.2).Death occurred in 33(40.2%) patients. Mortality was higher in those who stayed for 48hours (OR=5.6;95% CI 1.60-19.69; p=0.007) and in ventilated patients (OR=5.3; 95% CI 1.41-19.98; p=0.013).CONCLUSION:The observed mortality in this review was higher than the one in most reports. It was significantly high in patients who stayed for 48 hours and in those who required mechanical ventilatory support. 

scholarly journals Profile of Intensive Care Unit admission and Outcomes of Medical and Surgical patients at A Tertiary Government Hospital: A 5 Year Trend Analysis

2018 ◽  
Vol 29 (2) ◽  
pp. 59-62
Author(s):  
Shakera Ahmed ◽  
Omar Faruque Yusuf ◽  
AKM Shamsul Alam ◽  
Anisul Awal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Ventilatory Support ◽  
Surgical Patients ◽  
College Hospital ◽  
Medical College ◽  
Advanced Airway ◽  
Medical Discipline ◽  
Record Review

Background: The intensive care unit (ICU) is that part of the hospital where critically ill patients that require advanced airway, respiratory and haemodynamic supports are usually admitted. Intensive care unit admissions which aim at achieving an outcome better than if the patients were admitted into other parts of the hospital however come at a huge cost to the hospital, the personnel and patients’ relations.Objective: To audit the 5 year bed occupancy rate and outcome of medicine and surgical patients admitted into the ICU of the Chittagong Medical College Hospital, Chittagong, Bangladesh.Design: A 5 years retrospective study (Record review) from January 2012 to December 2016. Method: Data were extracted from the ICU records of the patient and analyzed.Results: During this study period, the frequency of admission into ICU was significantly more (p<0.001) from medical discipline (55.20%) than surgical disciplines (44.80%). The incidence of survival was significantly lower (p<0.001) from medical discipline (37.68%), than from surgical disciplines (49.05%). Occurrence of total ventilatory support provided in all disciplines was 60.32% and it was significantly higher for the surgical patients. Overall mortality rate was 57.23%.Conclusion: During prioritizing the patients for ICU admission surgical cases should get preference. It is primarily necessary to optimize patient to doctor ratio and patient to nurse ratio and providing the service by critical care physicians (“intensivists”) to reduce the mortality rate of ICU.Bangladesh J Medicine Jul 2018; 29(2) : 59-62

scholarly journals Five years experiences in diagnosis and management of jejuno-ileal atresia in Kanti children’s hospital

2020 ◽  
Vol 23 (2) ◽  
pp. 4-8
Author(s):  
Anupama Basnet ◽  
Bijay Thapa ◽  
Prativa Dhoubadel ◽  
Anuj Kayastha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Ventilatory Support ◽  
Morbidity Rate ◽  
Surgical Intensive Care Unit ◽  
Ileal Atresia ◽  
Surgical Intensive Care ◽  
Mortality And Morbidity ◽  
Jejunoileal Atresia ◽  
End To End

Introduction: Jejuno-ileal atresia is a major cause of neonatal intestinal obstruction. The aim of this study is to evaluate the incidence, clinical presentation, management, and outcome of jejunoileal atresia at our institute over a period of five years. Methods: The medical records of the patients with the diagnosis of jejunoileal atresia during a period of five years (April 2014 to April 2019) were obtained from the hospital record section and surgical intensive care unit, and were reviewed and analyzed. Results: There were 61 cases of jejunoileal atresia among 144 cases of intestinal atresia. Twenty-nine (47.5%) of them were male. Laparotomy with resection of atretic part with anti-mesenteric tapering enteroplasty and end to end anastomosis was done in 15, and resection without tapering enteroplasty with end to end anastomosis was done in 39 patients. Thirty-eight patients (62.3%) were discharged while Twenty-three (37.7%) cases were lost to mortality. Conclusions: Although the mortality and morbidity rate are high in jejunoileal atresia, early diagnosis, improvement in surgical technique, modern ventilatory support and advanced in intensive care unit has led to the significant increase in the survival rate.

Increased Healthcare-Associated Infections in a Surgical Intensive Care Unit Related to Boarding Non-Surgical Patients

2019 ◽  
Vol 20 (4) ◽  
pp. 332-337
Author(s):  
Edward K. Len ◽  
Ritesh Akkisetty ◽  
Sandia Royal ◽  
Maryanne Brooks ◽  
Susette Coyle ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Healthcare Associated Infections ◽  
Surgical Intensive Care ◽  
Healthcare Associated

scholarly journals The trauma burden on a tertiary surgical intensive care unit during the lockdown period in South Africa: A retrospective observational study

Trauma ◽  
2021 ◽  
pp. 146040862110191
Author(s):  
Albert GP van Zyl ◽  
Nadiya Ahmed ◽  
Ryan Davids
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Penetrating Trauma ◽  
Tertiary Hospital ◽  
Surgical Intensive Care Unit ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Time Period ◽  
Alcohol Sales

Background Trauma places a significant burden on scarce South African critical care resources. The impact of the lockdown period in 2020 on these resources has not been studied. Restrictions on citizen movement and alcohol sales during the lockdown period presented a unique time period to investigate the burden of trauma on a low–middle-income country tertiary hospital intensive care unit. Methods A retrospective observational analysis of all patients admitted to a tertiary hospital surgical intensive care unit during the lockdown period in 2020, compared to the same time period in 2019 and 2018. Data were analysed to detect if a significant difference was present in the number of trauma admissions, length of stay and mechanisms of trauma. Results A significant decrease in the number of trauma admissions to ICU in 2020 was observed as compared to 2018 and 2019 during the same period ( p = <0.001), with a reduction of nearly 50%. The incidence of trauma admissions was lower in all individual lockdown levels in 2020 as compared to 2018 and 2019, and the lowest incidence was recorded in level 5 of 2020. There was no difference among the length of stay of trauma patients in ICU in 2018, 2019 and 2020. There was no difference between the incidence of trauma admissions during lockdown level 3 (with and without alcohol sales) in 2020 compared to 2018. The profile of penetrating and non-penetrating trauma over the 3 years was the same ( p = 0.22). There were no interactions between years, lockdown periods and penetrating trauma ( p = 0.22). Interpretation There was a significant decrease in the trauma burden presented to the surgical ICU during the lockdown period in 2020. Levels with the strictest restrictions on movement and alcohol use had the greatest measurable impact. The decreased number of trauma patients admitted in 2020 was comparable to the national trend of decreased trauma numbers recorded in all levels of the national healthcare system.

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