Admission Patterns and Patient Outcomes in Intensive Care Delivery at a Rural Tertiary Hospital in Southern Nigeria: A Five-Year Retrospective Review.

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.