Iyoha Ehi-Iyoha, Okwilagwe Harry, Okonmah Kenneth U, Irabor Joseph, Olowo-Samuel Oluwatunmise, Aiyenuberun Segun V
College of Medicine, Ambrose Alli University, Ekpoma, NGA.
Research Unit, Internal Medicine Interest Group of Nigeria, Lagos, NGA.
Cureus. 2024 Nov 7;16(11):e73251. doi: 10.7759/cureus.73251. eCollection 2024 Nov.
Background Intensive care units (ICUs) play a vital role in managing critically ill patients, yet data on admission patterns and outcomes in rural healthcare settings, particularly in Nigeria, remain limited. Understanding these patterns is essential for improving patient care, especially in resource-limited, rural settings. This study aimed to investigate the admission and outcome patterns of patients admitted to the ICU at Irrua Specialist Teaching Hospital (ISTH), located in a rural part of Edo State, Nigeria. Method This was a retrospective study conducted at ISTH. Data on biodata, primary admission diagnosis, duration of admission, and patient outcomes were collected from the ICU register for all patients admitted to the ICU over a five-year period, from January 1, 2019, to December 31, 2023, and analyzed. Results During the five-year study period, there were 581 ICU admissions, of which 575 (99%) were included in the study after excluding six (1%) due to incomplete data. Among the patients, 297 (51.7%) were female. The young and middle-aged group (20-59 years) accounted for 60% (365) of admissions. Surgical cases comprised the majority of admissions at 57.9% (333), followed by medical cases at 25.9% (149) and obstetric/gynecologic cases at 16.2% (93). The most common sources of admission were general surgery (211, 36.7%), obstetrics (75, 13%), and neurosurgery (43, 7.5%), with the most frequent diagnoses being generalized peritonitis secondary to perforated viscus (102, 17.7%), bowel obstruction (36, 6.3%), preeclampsia/eclampsia (28,4.9%), traumatic brain injury (TBI) (27, 4.7%), and stroke (26, 4.5%). The overall mortality rate was 49.2% and was significantly associated with age, duration of admission, type of case, and subspecialty (p < 0.05). Conclusion The study highlights admission and outcome patterns that reflect the challenges faced in rural ICU settings. The high mortality rate highlights the need for improved critical care resources and targeted interventions to improve outcomes of critically ill patients in similar resource-limited settings.
背景 重症监护病房（ICU）在危重症患者的管理中起着至关重要的作用，但关于农村医疗环境，特别是尼日利亚的入院模式和治疗结果的数据仍然有限。了解这些模式对于改善患者护理至关重要，尤其是在资源有限的农村地区。本研究旨在调查位于尼日利亚江户州农村地区的伊鲁阿专科医院（ISTH）ICU收治患者 的入院和治疗结果模式。方法 这是一项在ISTH进行的回顾性研究。收集了2019年1月1日至2023年12月31日这五年期间所有入住ICU患者的生物数据、初次入院诊断、住院时间和患者治疗结果等数据，并进行分析。结果 在为期五年的研究期间，共有581例患者入住ICU，排除6例（1%）数据不完整的患者后，575例（99%）被纳入研究。患者中，297例（51.7%）为女性。青年和中年组（20 - 59岁）占入院人数的60%（365例）。手术病例占入院人数的大多数，为57.9%（333例），其次是内科病例，占25.9%（149例），产科/妇科病例占16.2%（93例）。最常见的入院科室来源是普通外科（211例，36.7%）、产科（75例，13%）和神经外科（43例，7.5%），最常见的诊断为脏器穿孔继发的弥漫性腹膜炎（102例，17.7%）、肠梗阻（36例，6.3%）、先兆子痫/子痫（28例，4.9%）、创伤性脑损伤（TBI）（27例，4.7%）和中风（26例，4.5%）。总体死亡率为49.2%，且与年龄、住院时间、病例类型和亚专业显著相关（p < 0.05）。结论 该研究突出了反映农村ICU环境中所面临挑战的入院和治疗结果模式。高死亡率凸显了在类似资源有限的环境中改善重症监护资源和针对性干预措施以提高危重症患者治疗结果的必要性。
