Morbidity Pattern and Outcome among Patients in Intensive Care Unit and Associated Factors, A Single Centre Experience in Dhaka, Bangladesh

Abstract

Introduction: An intensive care unit (ICU) is a special unit of hospital that provides intensive treatment for patients with severe or life-threatening illness and injuries, which require constant and close monitoring with life support equipment. Mortalities in Intensive Care Units (ICU) are high especially in the developing countries. The unpredictability of death rates is attributable to age, sex, morbidity pattern. severity of illness, well timed medical attention and total management facilities. Evaluation of morbidity pattern and outcome of admitted patient can assess the efficacy and overall grade of the ICU which making it possible to take better decisions for further improvement of quality of care. Materials & Methods: This is a retrospective, descriptive hospital record based study conducted in a newly established ICU at Kurmitola General Hospital, Dhaka, Bangladesh from March 2018 to December 2019 (22 months). The admission and discharge register of the ICU were used to extract information. The statistical analysis was carried out by using the Statistical Package for Social Science (SPSS), version 23.0. Results: A total of 575 (Male 293, Female 282) patients were admitted in this ICU over the 22 months period with the age range from 18-85 years. The primary cause of morbidity was medical cause 522 (90.78%) and rest are surgical cause 53 (9.22%). 207 (36%) of the patients died while other were improved and discharge 352 (61.22%) or referred to high centers 16 (2.78%). Respiratory disease 115 (20%), neurological disease 93 (16.17%) and cardiovascular disease 64 (11.13%) were the most prevalent reasons for ICU admission while respiratory disease 51 (24.64%) and cardiovascular disease 34 (16.72%) were the most important cause of mortality. Out of these 207 death, 123 (41.98%) were male and 84 (29.79%) were female. Mortality rate was significantly high among male (χ2=9.27, p-value=0.002). Mortality rate was 37.16% in medical cases and 24.52% in surgical cases. Among the admitted patients higher the length of stay (4 days or more), lower the mortality rate. Highest incidence of death 88 (42.51%) occurred for 1-3 days of ICU stay. Conclusion: The major cause of ICU admission among the patients were respiratory disease, neurological disease and cardiovascular disease. Respiratory disease and cardiovascular disease were the major contributor to the mortality. Male sex, geriatric patients, medical diagnosis and shorter duration of stay into ICU were associated with higher mortality rate.