Profile of Intensive Care Unit Admissions and Outcomes in a Tertiary Care Center of a Developing Country in West Africa: A 5 Year Analysis

Abstract

Objective: The objective was to determine the Profile of Intensive Care Unit admissions and outcomes in the Lagos University Teaching Hospital (LUTH). Materials and methods: The Lagos University Teaching Hospital ethical committee provided approval. A retrospective study of all patients admitted into the general Intensive care unit (ICU) of Lagos University Teaching Hospital (LUTH) from 1st of November 2010 to 30th of November 2015 was done. Data were collected from the ICU admission and discharge registers, and data analysis was done using Microsoft Excel 2007. Results: A total of 647 patients were admitted into the ICU, there were 352 (54.4) males and 295 (45.6) females giving a male to female ratio of 1.2: 1. The young and the middle aged group (20-59 years) accounted for 66.9% (433) of all the ICU admissions. The study showed that neurosurgical cases accounted for 32.0% (207) of all admissions into ICU while the lowest was from oral and maxillofacial surgery 0.1% (1). Severe traumatic brain injury accounted for 77.3% (160) of all Neurosurgical admission. Mortality rate was 61.4% (397) in our study and 38.7% (250) patients survived. There was no correlation between the age of patients and number of deaths across the specialty. Burns and plastics cases accounted for 4.9% (32) of all admissions into ICU of which 96.9% (31) of cases had a recorded percentage area of body surface burns. Patients referred from the specialty of Internal medicine made up 18.5% (119) of the total ICU admissions, while the most common medical indication for admission was Neurological cases 53.8% (64). Post-operative surgical care across all specialties accounted for 36.6% (237) of all ICU admission. Conclusion: Survival rate of patients in our ICU is uncomfortably low. The need to set up a local critical care medicine training program to produce intensive care physicians for the ICUs should be put in place to help improve the outcome of patients. Also, the absence of numerous data in our region on workload, outcome and costs, and the heterogeneity of ICUs, makes it evident that any recommendation about future provision will be highly speculative.