Audit of General Intensive Care Unit of Sir Salimullah Medical College, Mitford, Dhaka

Abstract

Background: Intensive care units provide care to patients with severe or life-threatening illnesses and injuries, which require constant support, close supervision from life support equipment and medication in order to ensure normal bodily functions. It is staffed by highly trained physicians, nurses and respiratory therapists who specialize in caring for critically ill patients. ICUs are also different from general hospital wards by a higher staff-to-patient ratio and access to advanced medical resources and equipment that is not routinely available somewhere else. Common conditions include acute respiratory distress syndrome, septic shock, and other life-threatening conditions that are treated within ICUs. Aim of the study: The aim of the study was to assess the operational power, existing facilities, bed requirement, patients source and follow up and to determine and analyze the mortality in the ICU of this institution. Methods: It was a retrospective study conducted in the General Intensive Care Unit of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh from January 2019 to December 2019. A total of 607 patients who had been taken admission in General ICU unit of the hospital was recruited as study population. According to the criteria of analysis already informed, data were collected from admission register and mortality record books. We divided the total number of patients into 4 age groups, 10-30 years, 31-45 years, 46-65 years and above 65 years. We calculated patients’ mortality and male female ratio. We also considered patients coming from different specialties those who were referred to the ICU. We observed the relationship of mortality with number of organ failure too. We categorized the patients as single, double or more organs involvement and its relationship with mortality. Duration of stay in the ICU was defined as the number of days between the admission in ICU and discharge with a minimum stay of one day and also more. Relationship with mortality and number of staying days was noticed. All data were collected within data collection sheets. Result: Hospital ICU mortality in an average was 45%. Patients with long ICU stay have higher mortality than shorter stay. Nonsurvivors were older than survivors. Patients from outside have a higher mortality (85%) than those from ward, postoperative and emergency (35%).25% of patients were in the intensive care unit for more than 3 days and shared 80% of bed occupancy. Much mortality was due to inappropriate early discharge, lack of meticulous attention before admission and inadequate care after discharge. Conclusion: So strengthening of facilities may be provided by appropriate transport system and acute medicine service at emergency and also by step down units or high dependency unit in ICU surroundings. Resources and study should be directed towards the low probable mortalities to improve the ICU outcome and to decrease the mortality percentage. Continuous advice and follow up should be provided to the patients after transferring to the ward, cabin or home.