Comparison Between Medical and Surgical Intensive Care Unit-A Ten-Year Review of The Management of Patients in A Resource-Poor Setting in The Niger-Delta Region of Nigeria.
DOI:
https://doi.org/10.47941/ijhmnp.1407Keywords:
Intensive Care Unit, Medical ICU, Surgical ICU, Outcome, Sex, Bill, Hospital stay.Abstract
Purpose: To compare the outcome of patients admitted to the ICU with Medical diagnoses against those with Surgical diagnoses.
Methodology: This is a ten-year retrospective study conducted at the University of Port Harcourt Teaching Hospital. Ethical approval for the study was sought and gotten from the hospital’s ethical committee. The information gotten includes history, age, sex, diagnosis, length of admission, and outcome. The data collected was analyzed and presented in tables and charts.
Findings: Three-quarters of the patients admitted to the ICU had surgical diagnoses. More patients with Medical diagnoses (102,19.7%) were discharged from the ICU compared to patients with surgical diagnoses (78,5%). More patients with Surgical diagnosis (919, 52.9%) were transferred out compared to patients with Medical diagnosis (140,27.1%). Patients admitted with medical diagnosis tend to be older and paid more and stayed longer in the ICU compared to patients with surgical diagnosis and this was statistically significant. Three-quarters of the patients admitted to the ICU have surgical diagnoses. More patients with medical diagnoses died in the ICU. Patients with medical diagnoses were older, stayed longer, and paid more for their ICU admission than surgical patients.
Unique contribution to theory, policy and practice: More patients with medical diagnoses died in the ICU. Hence the need for proper management of common medical ailments.
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Abhulimen Victor, Oruobu-Nwogu Ayanate. A ten-year review of the management of surgical patients in the Intensive Care Unit. World Journal of Advanced Research and Reviews,2023,19(01),657-666.
Abhulimen Victor, Oruobu-Nwogu Ayanate. A ten-year Review of the Management of Medical Patients in the Intensive Care Unit in a resource-poor setting in Southern Nigeria. American Journal of Health, Medicine and Nursing Practice. Vol.8, Issue 4, pp 31 – 42, 2023
Abubakar AS, Bako B, El-Nafaty AU, Mulima B, Muhammed A, Dibal JY. MRP.23 – 41.
Abebe K, Negasa T, Argaw F. Surgical admissions and treatment outcomes at a tertiary hospital intensive care unit in Ethiopia: a two-year review. Ethiopian Journal of Health Sciences. 2020 Sep 1;30(5).
Nates JL, Nunnally M, Kleinpell R, Blosser S, Goldner J, Birriel B, Fowler CS, Byrum D, Miles WS, Bailey H, Sprung CL. ICU admission, discharge, and triage guidelines: a framework to enhance clinical operations, development of institutional policies, and further research. Critical care medicine. 2016 Aug 1;44(8):1553-602.
Loftus TJ, Ruppert MM, Ozrazgat-Baslanti T, Balch JA, Shickel B, Hu D, Efron PA, Tighe PJ, Hogan WR, Rashidi P, Upchurch GR. Postoperative over triage to an intensive care unit is associated with a low value of care. Annals of Surgery. 2023 Feb 6;277(2):179-85.
Fowler NH, Dickinson M, Ghosh M, Chen AI, Andreadis C, Tiwari R, Masood A, Ramos R, Jousseaume E, Thieblemont C, Dreyling M. Assessment of healthcare resource utilization and hospitalization costs in patients with relapsed or refractory follicular lymphoma undergoing CAR-T cell therapy with tisagenlecleucel: results from the ELARA study. Transplantation and Cellular Therapy. 2023 Jan 1;29(1):60-e1.
Kannan S, Song Z. Changes in Out-of-Pocket Costs for US Hospital Admissions Between December and January Every Year. In; JAMA Health Forum 2023 May 5 (Vol. 4, No. 5, pp. e230784-e230784). American Medical Association.
Brown RB, Hosmer DA, Chen HC, Teres DA, Sands MI, Bradley SH, Opitz EL, Szwedzinski DO, Opalenik DO. A comparison of infections in different ICUs within the same hospital. Critical Care Medicine. 1985 Jun 1;13(6):472-6.
Gershengorn HB, Garland A, Gong MN. Patterns of daily costs differ for medical and surgical intensive care unit patients. Annals of the American Thoracic Society. 2015 Dec;12(12):1831-6.
Koch C, Edinger F, Fischer T, Brenck F, Hecker A, Katzer C, Markmann M, Sander M, Schneck E. Comparison of qSOFA score, SOFA score, and SIRS criteria for the prediction of infection and mortality among surgical intermediate and intensive care patients. World Journal of Emergency Surgery. 2020 Dec;15(1):1-0.
McNelis J, Schwall GJ, Collins JF. Robotic remote presence technology in the surgical intensive care unit. Journal of Trauma and Acute Care Surgery. 2012 Feb 1;72(2):527-30.
Johnson U, Ibeanusi S, Kejeh B. Audit of admissions and outcome of patients with burns in the intensive care unit of a Tertiary Hospital in Port Harcourt, Nigeria. Journal of Advances in Medical and Pharmaceutical Sciences. 2018 May 19;17(1):1-9.
Mato CN, Onwuchekwa AC, Aggo AT. The pattern of admissions to the University of Port Harcourt Teaching Hospital intensive care unit–a 10-year analysis. Southern African Journal of Critical Care. 2009;25(1).
Jaja BN, Eghwrudjakpor PO. Effect of demographic and injury etiologic factors on intensive care unit mortality after severe head injury in a low middle-income country. Annals of African medicine. 2014 Oct 1;13(4):204.
Green K, Orazulike N. Obstetric Admission into the Intensive Care Unit (ICU) of the University of Port Harcourt Teaching Hospital: A Ten-Year Review. Journal of Advances in Medicine and Medical Research. 2018 Mar 17;25(9):1-7.
Otokwala JG, John OC. A 365-Day Record of Maternal Admissions in Intensive Care Unit at the University of Port Harcourt Teaching Hospital in Nigeria. Journal of Biosciences and Medicines. 2023 Apr 3;11(4):296-303.
Jonathan E, Mazpa E, Chidubem O. Admissions and MMortalitypatterns in Intensive Care Delivery at Enugu State University of Science and Technology Teaching Hospital: A three-year retrospective study. Cereus 2022;14(7):e27195.
Sonneville R, Mazighi M, Collet M, Gayat E, Degos V, Duranteau J, Grégoire C, Sharshar T, Naim G, Cortier D, Jost PH. One-Year Outcomes in Patients with Acute Stroke Requiring Mechanical Ventilation. Stroke. 2023 Jul 27.
Dawson LP, Nehme E, Nehme Z, Davis E, Bloom J, Cox S, Nelson AJ, Okyere D, Anderson D, Stephenson M, Lefkovits J. Sex differences in epidemiology, care, and outcomes in patients with acute chest pain. Journal of the American College of Cardiology. 2023 Mar 14;81(10):933-45.
Oritiz D, Lindroth HL, Brady T et al. Delirium severity does not differ between medical and surgical intensive care units after adjusting for medication use. Sci Rep 2022; 12: 14447.
Szabó GV, Szigetváry C, Szabó L, Dembrovszky F, Rottler M, Ocskay K, Madzsar S, Hegyi P, Molnár Z. Point-of-care ultrasound improves clinical outcomes in patients with acute onset dyspnea: a systematic review and meta-analysis. Internal and Emergency Medicine. 2023 Mar;18(2):639-53.
Abate SM, Basu B, Jemal B, Ahmed S, Mantefardo B, Taye T. Pattern of disease and determinants of mortality among ICU patients on mechanical ventilator in Sub-Saharan Africa: a multilevel analysis. Critical Care. 2023 Dec;27(1):1-3.
Offiong BE, Salibi G, Tzenios N. Medical Brain Drain Scourge in Africa: Focusing on Nigeria. Cambridge Open Engage. doi:10.33774/coe-2023-vst08.
Ebeye T, Lee H. Down the brain drain: a rapid review exploring physician emigration from West Africa. Global Health Research and Policy. 2023 Jun 27;8(1):23.
Goštautaitė B, Mayrhofer W, Bučiūnienė I, Jankauskienė D. Mitigating medical brain drain: the role of developmental HRM and the focus on opportunities in reducing the self-initiated expatriation of young professionals. The International Journal of Human Resource Management. 2023 Jul 27:1-27.
Smith ZA, Adele Y, McDonald P. Outcomes in critical care Delivery at Jimma University Specialised Hospital, Ethiopia. Anaesth Intensive Care 2013; 41(3): 336-368.
Dosta JF, Mc Laughlin TP, Model SH, Piech CT. Daily cost of an intensive care unit day; the contribution of mechanical ventilation. Critical. Care Med. 2005;33(6):1266-71.
Vasilevskis EE, Chandraseklar R, Holtze CH, Graves J, Speroff T, Girard TD, Patel MB, Hughes CG, Cao A, Pandharipande PP, Ely EW. The cost of ICU Delirium and Coma in the Intensive Care Unit Patient. Med Care. 2018; 56(10):890- 897.
Peter D, Jean-Francis K, Monica N, Hubert W. More men than women are admitted to 9 intensive care units in British Columbia. Journal of Critical Care 2009;24(4):630.
Tasting IL, Megan KM, Heath DW. Gender differences in critical illness and critical care research. Clin Chest Med. 2021;42(3):543 -555.
Thompson K, Hammond N, Bailey M, Darvall J, Low G, McGloughlin S, Modra L, Pilcher D. Sex differences in long-term survival after intensive care unit treatment for sepsis: A cohort study. PloS One. 2023 Feb 24;18(2):e0281939.
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