Abstract:

Background: Surgical patients have been reported to be a major cause of hospitalization and intensive care utilization worldwide, they also consume a significant amount of the health care budget. There is a paucity of published data on intensive care utilization and outcomes of patients admitted to ICU from our environment. This study aimed to describe the common indications and predictors of outcome of surgical patients admitted to ICU.

Methods: This was a descriptive prospective cross sectional study involving surgical patients admitted to the ICU from August 2017 to May 2018. Univariate and multiple logistic regressions was used to identify independent factors associated with mortality.

Results: A total of 199 surgical patient representing 55.7% of all ICU admission were studied. Median age of patients was 32 years and majority of the patients were males 62%. Majority of patients, 138 (69.4%) were admitted for observation or close monitoring following surgery whereas 61 (30.7%) were admitted for mechanical ventilator. The specialty of general surgery had the highest number of patients admitted to the ICU (33.7%). The median length of stay (LOS) in ICU was 18 days. High ASA class, emergency surgery, high APACHE score, high temperature and presence of postoperative complications were the main predictors of prolonged LOS (p <0.001). The overall ICU mortality was 39% and it was significantly associated with advanced age (>65 years), delayed ICU admission (>72 hours), admission systolic BP < 90 mmHg, SPO2 < 90 need for ventilator support, high admission modified APACHE II score.

Conclusion: Postoperative observation/close monitoring following surgery and mechanical ventilator remains the most common indications for ICU admission in our setting. postoperative general surgical patients were observed to be the highest surgical specialty utilizing the ICU bed spaces calls for strengthening surgical care in this region to reduce the burden of surgical diseases on critical care services.